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Individual

DR. CANDIDA JANE LUTES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3500 OAK LAWN AVE., SUITE 275, DALLAS, TX 75219-4308
(214) 522-0498
(214) 522-0454
Mailing address
3500 OAK LAWN AVE., SUITE 275, DALLAS, TX 75219-4308
(214) 522-0498
(214) 522-0454

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
21711
TX
103TC0700X
Clinical Psychologist
21711
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00334369-01
TX
05
0334379-01
TX
Enumeration date
07/11/2005
Last updated
03/16/2011
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