MEDICARE: CECILA KARL 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	207R00000X	Internal Medicine Physician	K3769	TX

General Provider Information

NPI Number	:	1932100468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILA KARL MD

Provider Business Mailing Address
First Line	:	909 9TH AVE
Second Line	:	STE 300
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3903
Country	:	US
Telephone Number	:	817-336-7191
Fax Number	:	817-332-3172

Provider Business Practice Location Address
First Line	:	909 9TH AVE
Second Line	:	STE 300
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3903
Country	:	US
Telephone Number	:	817-336-7191
Fax Number	:	817-332-3172

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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