Provider Demographics
NPI:1407292303
Name:FRANKLIN, TARA ALICIA
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:ALICIA
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 WHITE CAP CT
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3896
Mailing Address - Country:US
Mailing Address - Phone:469-297-4042
Mailing Address - Fax:
Practice Address - Street 1:1725 WHITE CAP CT
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-3896
Practice Address - Country:US
Practice Address - Phone:469-297-4042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion