Healthcare Provider Details

I. General information

NPI: 1669260162
Provider Name (Legal Business Name): RULA KHALAF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1067 TWINING DR BLDG 4666
BARKSDALE AFB LA
71110-2486
US

IV. Provider business mailing address

1067 TWINING DR BLDG 4666
BARKSDALE AFB LA
71110-2486
US

V. Phone/Fax

Practice location:
  • Phone: 318-456-6718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number31061
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: