Organization
KALLAL BROS, LLC
Active
Other names
RISE Men's Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KALLAL (MEMBER)
(817) 915-1520
Entity
Organization
Contact information
Practice address
400 S OAK ST STE 120, ROANOKE, TX 76262-6789
(817) 900-0304
(817) 900-0432
Mailing address
400 S OAK ST STE 120, ROANOKE, TX 76262-6789
(817) 900-0304
(817) 900-0432
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H7766
LICENSE
TX
Enumeration date
11/20/2018
Last updated
04/15/2025
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