Provider Demographics
NPI:1780890236
Name:FRANKLIN, DOUGLAS DUANE (MED, LPC, CART)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:DUANE
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:MED, LPC, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-8435
Mailing Address - Country:US
Mailing Address - Phone:409-781-5476
Mailing Address - Fax:
Practice Address - Street 1:6767 HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-8435
Practice Address - Country:US
Practice Address - Phone:409-781-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health