Provider Demographics
NPI:1679770713
Name:REEVES, CANDACE D (NP)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:D
Last Name:REEVES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ARC SOUTHWEST
Mailing Address - Street 2:1807 SLAUGHTER LANE, SUITE 490
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6237
Mailing Address - Country:US
Mailing Address - Phone:512-282-8967
Mailing Address - Fax:
Practice Address - Street 1:ARC SOUTHWEST AFTER HOURS
Practice Address - Street 2:1807 SLAUGHTER LANE, SUITE 490
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6237
Practice Address - Country:US
Practice Address - Phone:512-282-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP108693363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159078801Medicaid
TX159078802Medicaid
TX159078807Medicaid
TX159078805Medicaid
TX159078804Medicaid
TX159078808Medicaid
TX159078804Medicaid
TXTXB119139Medicare PIN