MEDICARE: QUANAH SKY FRANKLIN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA12740	TX

General Provider Information

NPI Number	:	1770142044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUANAH SKY FRANKLIN PA-C

Provider Business Mailing Address
First Line	:	4150 N COLLINS ST STE 100
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-4547
Country	:	US
Telephone Number	:	817-337-6604
Fax Number	:	817-337-6866

Provider Business Practice Location Address
First Line	:	4150 N COLLINS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-4547
Country	:	US
Telephone Number	:	817-337-6044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2019
Last Update Date	:	07/26/2023

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