Provider Demographics
NPI:1962225086
Name:OLSON, CANDICE (RSPS)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:RSPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 NW CENTRAL DR STE 107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2034
Mailing Address - Country:US
Mailing Address - Phone:346-775-5315
Mailing Address - Fax:
Practice Address - Street 1:5600 NW CENTRAL DR STE 107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-2034
Practice Address - Country:US
Practice Address - Phone:346-775-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1763-0423175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1763-0423OtherCOMMERCIAL INSURANCE