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Individual

DARRIN C D'AGOSTINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
N3592
TX
207R00000X
Internal Medicine Physician
000503
CT
207R00000X
Internal Medicine Physician
Primary
N3592
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
197923901
TX
05
197923903
TX
01
8CV866
BCBS
TX
01
8X9569
BCBS
TX
Enumeration date
07/31/2006
Last updated
07/22/2011
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