Provider Demographics
NPI:1598031841
Name:BEEN, CANDACE FRANCES (DPM, PAC)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:FRANCES
Last Name:BEEN
Suffix:
Gender:F
Credentials:DPM, PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 HILBIG RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1448
Mailing Address - Country:US
Mailing Address - Phone:936-520-5951
Mailing Address - Fax:
Practice Address - Street 1:806 HILBIG RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1448
Practice Address - Country:US
Practice Address - Phone:936-520-5951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004286L213E00000X
PAMA003432L363AM0700X
TXPA08606L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD53-0196960Medicaid