Provider Demographics
NPI:1023096849
Name:LIPSHY, CANDACE E (OD)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:E
Last Name:LIPSHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CANDACE
Other - Middle Name:LIPSHY
Other - Last Name:ALPAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5311 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4161
Mailing Address - Country:US
Mailing Address - Phone:806-359-3937
Mailing Address - Fax:806-359-8124
Practice Address - Street 1:5311 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4161
Practice Address - Country:US
Practice Address - Phone:806-359-3937
Practice Address - Fax:806-359-8124
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3717TG152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX410022972OtherTEXAS RAILROAD MEDICARE
TX20117426OtherTEXAS DPS
TX0192254Medicaid
TX3717TGOtherOPTOMETRIC LICENSE NUMBER
TX0192254Medicaid
TX410022972OtherTEXAS RAILROAD MEDICARE