Healthcare Provider Details

I. General information

NPI: 1780883173
Provider Name (Legal Business Name): ALLISON HAMPTON FARRELL AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 05/02/2020
Certification Date: 05/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 CENTRAL PARK DR
ARLINGTON TX
76014-2069
US

IV. Provider business mailing address

409 CENTRAL PARK DR
ARLINGTON TX
76014-2069
US

V. Phone/Fax

Practice location:
  • Phone: 817-261-9191
  • Fax: 817-784-6880
Mailing address:
  • Phone: 817-261-9191
  • Fax: 817-784-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number60526
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: