Individual provider Active NPI

Candice Dean, DO

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1174878540
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q3503 Issued in TX
Practice address
323 E Hawkins Pkwy
Longview, TX 75605-7905
Phone
(903) 544-6780
Fax
(903) 544-6799
NPI assigned
Jul 20, 2012
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q3503 TX Primary

Addresses

Primary practice location

323 E Hawkins Pkwy
Longview, TX 75605-7905

Mailing address

PO Box 4207
Longview, TX 75606-4207
Phone (903) 315-4119

Other practice location 1

701 E Marshall Ave Ste 400
Longview, TX 75601-5595
Phone (903) 315-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615000768 TX Practitioner - Internal Medicine 6709197999 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

703 E Marshall Ave
Longview, TX 75601-5500

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Mar 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Mar 1, 2020 Accepting new patients
East Texas Border Health Clinic Past Accepting new patients

Locations

1600 Broadway Ave
Gladewater, TX 75647
Phone (903) 315-5630

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

323 E Hawkins Pkwy
Longview, TX 75605
Phone (903) 315-2000

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

701 E Marshall Ave
Ste 400
Longview, TX 75601
Phone (903) 315-1696

703 E Marshall Ave
Ste 1001
Longview, TX 75601
Phone (903) 753-7291

815 S Washington Ave
Ste 100
Marshall, TX 75670
Phone (903) 927-6094

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: cdean149513@christushealth.direct-ci.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1174878540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4207",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756064207",
            "telephone_number": "903-315-4119",
            "fax_number": "903-315-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E HAWKINS PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057905",
            "telephone_number": "903-544-6780",
            "fax_number": "903-544-6799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 E Marshall Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015595",
            "country_code": "US",
            "telephone_number": "903-315-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "CANDICE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q3503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.