Provider Demographics
NPI:1992343420
Name:PARRACK, CANDICE ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:ELIZABETH
Last Name:PARRACK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W BAKER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2386
Mailing Address - Country:US
Mailing Address - Phone:281-839-7428
Mailing Address - Fax:855-846-9859
Practice Address - Street 1:1001 W BAKER RD STE 101
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2386
Practice Address - Country:US
Practice Address - Phone:281-839-7428
Practice Address - Fax:855-846-9859
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143538363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily