Provider Demographics
NPI:1720305733
Name:ALLEN, CANDICE (MD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:ALLEN-JARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7 LANCEPINE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-5402
Mailing Address - Country:US
Mailing Address - Phone:832-257-1100
Mailing Address - Fax:
Practice Address - Street 1:6922 W RAYFORD RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-3003
Practice Address - Country:US
Practice Address - Phone:832-257-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ91092080P0006X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ9101OtherTMB