Provider Demographics
NPI:1073491494
Name:CARABALLO, CALLIE (RDMS)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:CARABALLO
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
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Mailing Address - Street 1:2701 LOS ALAMOS TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-2837
Mailing Address - Country:US
Mailing Address - Phone:432-288-4567
Mailing Address - Fax:817-971-0070
Practice Address - Street 1:252 S ELM ST STE A
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2258
Practice Address - Country:US
Practice Address - Phone:817-381-2002
Practice Address - Fax:817-971-0070
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL1370762085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound