Organization
CANDLELIGHT CARE PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONDE M FERGUSON FNP (OWNER OF ENTITY)
(214) 542-1907
Entity
Organization
Contact information
Practice address
190 S COLLINS RD STE 100, SUNNYVALE, TX 75182-4623
(214) 542-1907
(661) 221-7156
Mailing address
3919 POPLAR POINT DR, ROCKWALL, TX 75032-9276
(214) 542-1907
(661) 221-7158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/18/2019
Last updated
12/05/2019
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