Provider Demographics
NPI:1174241673
Name:KALO, RAFEL (PHARMD)
Entity type:Individual
Prefix:
First Name:RAFEL
Middle Name:
Last Name:KALO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 DANCING LIGHT LN
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8851
Mailing Address - Country:US
Mailing Address - Phone:832-659-8118
Mailing Address - Fax:
Practice Address - Street 1:600 W ARBROOK BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3702
Practice Address - Country:US
Practice Address - Phone:817-417-1602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist