Provider Demographics
NPI:1023227717
Name:JANTZ, CANDICE PIMLAPAH (MD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:PIMLAPAH
Last Name:JANTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8267 ELMBROOK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4078
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:3108 MIDWAY RD STE 104
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8485
Practice Address - Country:US
Practice Address - Phone:972-398-0393
Practice Address - Fax:972-398-0499
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM6674207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1868812-03Medicaid
TX8CV781OtherBCBS
TX8CV781OtherBCBS