MEDICARE: CANDICE JABUR

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	163W00000X	Registered Nurse	840240	TX
2	363LP0200X	Pediatric Nurse Practitioner	1141974	TX

General Provider Information

NPI Number	:	1750131785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE JABUR

Provider Business Mailing Address
First Line	:	913 FREESIA DR
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-4603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 N COIT RD STE 2302
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6663
Country	:	US
Telephone Number	:	469-290-3208
Fax Number	:

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

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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Directions to “ CANDICE JABUR ” Practice Location

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