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NPI Code Detail

MEDICARE: DR. VICTOR C KALU M.D.

MEDICARE:  DR. VICTOR C KALU  M.D.
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
1207RN0300XNephrology PhysicianJ5226TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00676289OTHERMEDICARE RAILROAD
9930050846OTHERTXMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1930080795OTHERTXRAILROAD
38AC240OTHERTXBCBS
4930080796OTHERTXRAILROAD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
686722JOTHERTXBCBS
786940JOTHERTXBCBS
889192FOTHERTXBCBS
10MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841276029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VICTOR C KALU M.D.
Provider Business Mailing Address
First Line : 26 WINDING HOLLOW LN
Second Line :
City : COPPELL
State : TX
Zip : 75019-6436
Country : US
Telephone Number : 817-988-8345
Fax Number :
Provider Business Practice Location Address
First Line : 4401 BOOTH CALLOWAY RD
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-7371
Country : US
Telephone Number : 817-988-8345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 05/16/2012

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Directions to “ DR. VICTOR C KALU M.D.” Practice Location

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