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General NPI Number Information
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NPI Number | 1821696386
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Entity Type | Organization
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Legal Business Name | BLUE OCEAN HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 105 CLARIDEN RANCH RD
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City | SOUTHLAKE
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State | TX
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Zip | 76092-1947
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Country | US
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Telephone | 817-835-6363
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Fax | 817-818-1313
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Provider Business Mailing Address
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Address Line | 105 CLARIDEN RANCH RD
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City | SOUTHLAKE
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State | TX
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Zip | 76092-1947
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Country | US
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Telephone | 817-835-6363
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Fax | 817-818-1313
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. KARA CHARLOTTE FARLEY
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Credential |
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Telephone | 281-785-2476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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