Provider Demographics
NPI:1881429033
Name:FRANSEN, STACEY
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:FRANSEN
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 1:15718 TENBURY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77040-1262
Mailing Address - Country:US
Mailing Address - Phone:203-809-1003
Mailing Address - Fax:
Practice Address - Street 1:15718 TENBURY ST
Practice Address - Street 2:
Practice Address - City:JERSEY VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:77040-1262
Practice Address - Country:US
Practice Address - Phone:203-809-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1133965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist