Healthcare Provider Details

I. General information

NPI: 1982582938
Provider Name (Legal Business Name): YSABELLE CALARA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 NE LAWRIE TATUM RD
LAWTON OK
73507-3002
US

IV. Provider business mailing address

3502 E GORE BLVD APT 6302
LAWTON OK
73501-9019
US

V. Phone/Fax

Practice location:
  • Phone: 580-354-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7971169
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: