MEDICARE: BERYL KALUL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME151515	FL
2	207Q00000X	Family Medicine Physician	T5590	TX

General Provider Information

NPI Number	:	1679034714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERYL KALUL MD

Provider Business Mailing Address
First Line	:	6080 S HULEN ST STE 360
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4810
Country	:	US
Telephone Number	:	817-607-8526
Fax Number	:

Provider Business Practice Location Address
First Line	:	8450 EAST FWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-4413
Country	:	US
Telephone Number	:	817-607-8526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2019
Last Update Date	:	03/19/2026

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