Healthcare Provider Details

I. General information

NPI: 1609795574
Provider Name (Legal Business Name): FARAH LARA AL HOURI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BARNES ST APT H11
CARRBORO NC
27510-2259
US

IV. Provider business mailing address

200 BARNES ST APT H11
CARRBORO NC
27510-2259
US

V. Phone/Fax

Practice location:
  • Phone: 312-752-7006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14748
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: