Provider Demographics
NPI:1114976529
Name:FARLEY, ROCHELLE E (DO)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:E
Last Name:FARLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18059 HWY 105 WEST
Mailing Address - Street 2:STE 125
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356
Mailing Address - Country:US
Mailing Address - Phone:936-582-6622
Mailing Address - Fax:936-582-5695
Practice Address - Street 1:18059 HWY 105 WEST
Practice Address - Street 2:STE 125
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356
Practice Address - Country:US
Practice Address - Phone:936-582-6622
Practice Address - Fax:936-582-5695
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00816305OtherRAILROAD
TX8C5943Medicare ID - Type Unspecified
TX8L21067Medicare PIN
E79594Medicare UPIN
TX352000YUAKMedicare PIN