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Individual

CANDIS M LOVELACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4400 HERITAGE TRACE PARKWAY, SUITE 200, FORT WORTH, TX 76244
(817) 380-1087
(817) 380-1088
Mailing address
4400 HERITAGE TRACE PARKWAY, SUITE 200, FORT WORTH, TX 76244
(817) 380-1087
(817) 380-1088

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
N3845
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208491501
TX
01
8CC632
BCBS
TX
Enumeration date
02/07/2007
Last updated
08/14/2012
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