MEDICARE: CARSON FARLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	81132	TX

General Provider Information

NPI Number	:	1932961059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARSON FARLEY

Provider Business Mailing Address
First Line	:	705 RIVERPLACE DR APT 1119
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-2154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4618 SW LOOP 820
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4400
Country	:	US
Telephone Number	:	817-763-9993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	01/24/2024

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