Organization
CERULEAN KOI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA BYNAUM (OWNER)
(682) 477-3756
Entity
Organization
Contact information
Practice address
110 W RANDOL MILL RD STE 243, ARLINGTON, TX 76011-4611
(682) 477-3756
(469) 833-4712
Mailing address
110 W RANDOL MILL RD STE 243, ARLINGTON, TX 76011-4611
(682) 477-3756
(469) 833-4712
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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