Provider Demographics
NPI:1972565794
Name:FRANKLIN, LISA ALICE (DDS)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ALICE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 S ALAMEDA ST STE A
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1797
Mailing Address - Country:US
Mailing Address - Phone:361-992-9500
Mailing Address - Fax:
Practice Address - Street 1:3435 S ALAMEDA ST STE A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1797
Practice Address - Country:US
Practice Address - Phone:361-992-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX163451223P0106X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16345OtherSTATE DENTAL LICENSE