Individual
BLAINE LEE FARLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2010 W KATHERINE P RAINES RD, SUITE 300, CLEBURNE, TX 76033-7435
(817) 556-3212
(817) 556-2388
Mailing address
2010 W KATHERINE P RAINES RD, SUITE 300, CLEBURNE, TX 76033-7435
(817) 556-3212
(817) 556-2388
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J1659
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047918001
—
TX
Enumeration date
06/06/2006
Last updated
09/16/2016
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