Basic Information
Provider Information
NPI: 1952836603
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKLIN
FirstName: ELIZABETH
MiddleName: VICTOR
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: VICTOR
OtherFirstName: ELIZABETH
OtherMiddleName: CHRISTINE
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: PH.D.
OtherLastNameType: 1
Mailing Information
Address1: 6000 W RAYFORD RD APT 2111
Address2:  
City: SPRING
State: TX
PostalCode: 773892207
CountryCode: US
TelephoneNumber: 8032926073
FaxNumber:  
Practice Location
Address1: 1935 MEDICAL DISTRICT DR
Address2:  
City: DALLAS
State: TX
PostalCode: 752357701
CountryCode: US
TelephoneNumber: 2144567000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2017
LastUpdateDate: 12/20/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X37630TXY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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