Provider Demographics
NPI:1225494313
Name:KAHLABRIA MEDICAL SERVICES
Entity type:Organization
Organization Name:KAHLABRIA MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-488-3431
Mailing Address - Street 1:2607 WOLFLIN AVE
Mailing Address - Street 2:144
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1825
Mailing Address - Country:US
Mailing Address - Phone:323-488-3431
Mailing Address - Fax:
Practice Address - Street 1:2607 WOLFLIN AVE
Practice Address - Street 2:144
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1825
Practice Address - Country:US
Practice Address - Phone:323-488-3431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty