Candace Renee Davis

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-125945 Issued in TX

Practice address

1710 Moores LN
Texarkana, TX 75503-1858

Phone

(903) 794-2705

NPI assigned

Jul 7, 2020

Last updated

Jul 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Temple Memorial Pediatric Center Inc.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Texarkana, TX
  • NPI 1972654663
  NPD

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1447878442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031858",
            "telephone_number": "903-794-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031858",
            "telephone_number": "903-794-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CANDACE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-20-125945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonali Das, OD
• Mark Charles Davies, OD
• Davis Home Care, LLC (Home Helpers/Direct Link)
• Amy Karen Davis, FNP
• Ashley Davis, RD, RDN
• Catherine Kayleigh Davis, APRN, FNP-C
• Jacqueline Davis, OT-A
• Terry Lee Davis
• Melissa Davison, M.S., LPC
• Zubaer M. Dawlah, M.D.

• Behavior Technician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.