Provider Demographics
NPI:1740286202
Name:KALAFUT, ROBERTA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:MARIE
Last Name:KALAFUT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 ANTILLEY RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5205
Mailing Address - Country:US
Mailing Address - Phone:325-795-1888
Mailing Address - Fax:325-795-9537
Practice Address - Street 1:1888 ANTILLEY RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5205
Practice Address - Country:US
Practice Address - Phone:325-795-1888
Practice Address - Fax:325-795-9537
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2625174400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5507518OtherAETNA
TX81T421OtherBCBS
TXCR1046OtherMCR RXR
TX116346104OtherFIRSTCARE/ADC
TX250008692OtherMEDICARE RR
TX8X7152OtherBCBS/ADC
TX102407701Medicaid
TX116346100OtherFIRSTCARE
TX130610202OtherMEDICAID/ADC
TX102407701Medicaid
TX116346100OtherFIRSTCARE