KALLAL BROS, LLC (NPI# 1780153734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780153734 |
| Entity Type | Organization |
| Organization Name | KALLAL BROS, LLC |
| Practice Address |
1104 N Highway 377 Ste 200 Roanoke TX 76262-9124 |
| Mailing Address |
220 Sorrel Trl Keller TX 76248-3117 |
| Practice Telephone | 8179151520 |
| Mailing Telephone | 8179151520 |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |
| Authorized Official Name | JOHN KALLAL (MEMBER) |
| Authorized Official Telephone | 8179151520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LICENSE | H7766 | 01 |
| Other Name | Type Code |
|---|---|
| RISE Men's Health | Doing Business As Name - Organization |
| Street Address |
1104 N HIGHWAY 377 STE 200 |
| City | ROANOKE |
| State | TX |
| Zip Code | 76262-9124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740722669 | Humaira Hassan | Optometrist | 1104 N Highway 377 Ste 200, Roanoke, TX 76262-9124 | 2016-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025611 | Freeform Chiropractic Trophy Club LLC | Chiropractor | 2240 Sh 114, Suite 650, Trophy Club, TX 76262 | 2020-02-20 |
| 1932748498 | Legacy Physical Therapy and Wellness | Physical Therapist | 351 N Byron Nelson Blvd, Suite 110, Roanoke, TX 76262 | 2020-01-02 |
| 1497399687 | Roanoke Foot & Ankle Institute, Pllc | Podiatrist | 351 W Byron Nelson Blvd, Suite 100, Roanoke, TX 76262 | 2019-10-31 |
| 1710470810 | Maria Guadalupe Madera | Dentist | 5000 Highway 114, Unit 130, Northlake, TX 76262 | 2018-06-13 |
| 1912414251 | 6 Day Dental Group - Roanoke, Pllc | Clinic/Center | 200 Tx-114, Roanoke, TX 76262 | 2018-01-09 |
| 1144746561 | Lone Star Neurosurgical Assistants | Physician Assistant | 1270 Casa Bella Ct, Westlake, TX 76262 | 2017-08-17 |
| 1710347562 | Randolph R West Dds Pllc | Dentist | 295 W. Byron Nelson Blvd, Ste 304, Roanoke, TX 76262 | 2016-03-07 |
| 1912367228 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 35 Arta Dr, Westlake, TX 76262 | 2016-02-29 |
| 1952760050 | Roanoke Dental Group,pc | Dentist | 1320 N Hwy 377 Suite 100, Roanoke, TX 76262 | 2016-02-17 |
| 1942683115 | Fatima Naurose Siraj | Dentist | 860 East Highway 114 Ideal Dental, Suite 200, Roanoke, TX 76262 | 2015-07-07 |
| Find all providers in zip 76262 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1710315825 | Express Family Care, LLC | Clinic/Center | 3960 Valley Gateway Blvd, Suite 1-a, Roanoke, VA 24012-6858 | 2013-10-29 |
| 1053634873 | Roanoke Partners In Health, PC | Clinic/Center | 3239 Electric Rd, Suite A, Roanoke, VA 24018-6444 | 2010-03-08 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.