MEDICARE: DR. CANDACE SUE KASPER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZD0900X	Dermatopathology (Pathology) Physician	F9650	TX

General Provider Information

NPI Number	:	1689616450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CANDACE SUE KASPER M.D.

Provider Business Mailing Address
First Line	:	2840 KELLER SPRINGS RD
Second Line	:	SUITE 1104
City	:	CARROLLTON
State	:	TX
Zip	:	75006-4829
Country	:	US
Telephone Number	:	214-483-2100
Fax Number	:	214-483-2104

Provider Business Practice Location Address
First Line	:	2840 KELLER SPRINGS RD
Second Line	:	SUITE 1104
City	:	CARROLLTON
State	:	TX
Zip	:	75006-4829
Country	:	US
Telephone Number	:	214-483-2100
Fax Number	:	214-483-2104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/08/2007

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