Organization
TRINITY DIAGNOSTIC CLINIC, P.A
Active
Organization
TRINITY DIAGNOSTIC CLINIC, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOSURI B RAJU M.D. (PRESIDENT)
(817) 905-2254
Entity
Organization
Contact information
Practice address
6324 SOUTHERN HILLS DR, FORT WORTH, TX 76132-4485
(817) 905-2254
Mailing address
6324 SOUTHERN HILLS DR, FORT WORTH, TX 76132
(817) 905-2254
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
G7866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123216705
—
TX
Enumeration date
06/03/2016
Last updated
06/03/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up