Provider Demographics
NPI:1710037023
Name:MCDANIEL, CANDACE FREEMAN (DO)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:FREEMAN
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6086
Mailing Address - Country:US
Mailing Address - Phone:817-800-3188
Mailing Address - Fax:214-328-4819
Practice Address - Street 1:8021 EAST R. L. THORNTON FRWY
Practice Address - Street 2:SUITE A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228
Practice Address - Country:US
Practice Address - Phone:214-328-4848
Practice Address - Fax:214-328-4819
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7336207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine