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Organization
T & R CLINIC A PROFESSIONAL ASSOCIATION
Active
Organization
T & R CLINIC A PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUCHITA D. REDDY M.D. (PRESIDENT/MEDICAL DOCTOR)
(817) 831-0321
Entity
Organization
Contact information
Practice address
2919 MARKUM DRIVE, FORT WORTH, TX 76117-4004
(817) 831-0321
(817) 831-3211
Mailing address
2919 MARKUM DRIVE, FORT WORTH, TX 76117-4004
(817) 831-0321
(817) 831-3211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M1311
TX
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92104103
—
TX
01
—
CP0037
RAILROAD MEDICARE
TX
Enumeration date
05/15/2006
Last updated
09/24/2010
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