Provider Demographics
NPI:1548985765
Name:DAVIS YEARBY, CANDACE
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:DAVIS YEARBY
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 1:3409 COYOTE WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-2824
Mailing Address - Country:US
Mailing Address - Phone:972-762-5137
Mailing Address - Fax:
Practice Address - Street 1:3409 COYOTE WAY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-2824
Practice Address - Country:US
Practice Address - Phone:972-762-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator