Healthcare Provider Details

I. General information

NPI: 1770142044
Provider Name (Legal Business Name): QUANAH SKY FRANKLIN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 N COLLINS ST
ARLINGTON TX
76005-4547
US

IV. Provider business mailing address

4150 N COLLINS ST STE 100
ARLINGTON TX
76005-4547
US

V. Phone/Fax

Practice location:
  • Phone: 817-337-6044
  • Fax:
Mailing address:
  • Phone: 817-337-6604
  • Fax: 817-337-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA12740
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: