KALLAL BROS LLC NPI 1780153734

NPI Information

NPI: 1780153734
Provider Name: KALLAL BROS, LLC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
:
Address: 400 S OAK ST STE 120
ROANOKE, TX
ZIP 76262
Phone: (817) 900-0304

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NPI Details

KALLAL BROS, LLC is a primary care clinic center in Roanoke, TX. KALLAL BROS, LLC NPI is 1780153734. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

400 S OAK ST STE 120
ROANOKE, TX
ZIP 76262-789
Phone: (817) 900-0304
Fax: (817) 900-0432

The provider's authorized official is John Kallal .
The authorized official title is Member and has the following contact phone number (817) 915-1520.

The enumeration date for this NPI number is 11/20/2018 and was last updated on 4/15/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H7766	OTHER	TEXAS	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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