Provider Demographics
NPI:1316105620
Name:TEUNIS, CANDICE BRAERMAN (MD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:BRAERMAN
Last Name:TEUNIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:281-344-1715
Mailing Address - Fax:
Practice Address - Street 1:1517 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4932
Practice Address - Country:US
Practice Address - Phone:281-344-1715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6712207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288586501Medicaid
TX288586502Medicaid
TX9022686OtherAETNA
TX8AD236OtherBCBS
TX288586503Medicaid
TX288586504Medicaid
TXTXB143838Medicare PIN
TX288586502Medicaid
TX288586501Medicaid
TXTXB143837Medicare PIN
TX8AD236OtherBCBS