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Individual

MIA RAJ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
801 7TH AVE, FORT WORTH, TX 76104-2796
(682) 885-4000
Mailing address
4708 BEHRENS CT, COLLEYVILLE, TX 76034-4345
(817) 692-1611

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT93224
TX
133V00000X
Registered Dietitian
Primary
TEMPMJ
TX

Other

Enumeration date
05/29/2026
Last updated
06/05/2026
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