Provider Demographics
NPI:1639987365
Name:CANDELARIO, ILKA TAMAR
Entity type:Individual
Prefix:DR
First Name:ILKA
Middle Name:TAMAR
Last Name:CANDELARIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 NORMANDY FOREST CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-5184
Mailing Address - Country:US
Mailing Address - Phone:832-832-0594
Mailing Address - Fax:
Practice Address - Street 1:3311 NORMANDY FOREST CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-5184
Practice Address - Country:US
Practice Address - Phone:346-525-6279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No175L00000XOther Service ProvidersHomeopath