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Organization
TRINITY DIAGNOSTIC CLINIC, PA
Active
Organization
TRINITY DIAGNOSTIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOSURI B. RAJU MD (OWNER)
(817) 332-2009
Entity
Organization
Contact information
Practice address
909 9TH AVE, SUITE 405, FORT WORTH, TX 76104-3903
(817) 332-2009
(817) 877-0122
Mailing address
PO BOX 33908, FORT WORTH, TX 76162-3908
(817) 332-2009
(817) 877-0122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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