| Kallal Medical Group | |
|
240 N Rufe Snow Dr Keller TX 76248-4226 | |
| (817) 431-0606 | |
| (817) 379-0155 |
| Full Name | Kallal Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 240 N Rufe Snow Dr, Keller, Texas |
| Authorized Official Name and Position | Kevin J Kallal (OWNER/PRESIDENT) |
| Authorized Official Contact | 8174310606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kallal Medical Group 5015 Fort Ave Waco TX 76710-5828 Ph: (817) 431-0606 | Kallal Medical Group 240 N Rufe Snow Dr Keller TX 76248-4226 Ph: (817) 431-0606 |
| NPI Number | 1891965505 |
|---|---|
| Provider Enumeration Date | 03/10/2008 |
| Last Update Date | 12/19/2019 |
| Certification Date | 12/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891965505 | NPI | - | NPPES |
| 1861408205 | Other | TX | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H7766 (Texas) | Primary |
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