Provider Demographics
NPI:1720142458
Name:FRANCISCO, AILEEN C (MD)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:C
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6155
Mailing Address - Country:US
Mailing Address - Phone:615-565-1733
Mailing Address - Fax:615-296-0151
Practice Address - Street 1:HWY 31 WEST FM206
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75709
Practice Address - Country:US
Practice Address - Phone:903-592-3257
Practice Address - Fax:903-592-3447
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00200573OtherPROVIDER RAILROAD NUMBER
TX8K5234OtherPROVIDER BCBS NUMBER
TXI25113Medicare UPIN
TX8D1824Medicare ID - Type UnspecifiedPROVIDER MEDICARE NUMBER