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Individual

HARIKRISHNA KOTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-7211
Mailing address
709 HELMSLEY PL, SOUTHLAKE, TX 76092-8641
(551) 556-4158

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
258946
MA
207R00000X
Internal Medicine Physician
Primary
Q7904
TX
208M00000X
Hospitalist Physician
258946
MA

Other

Enumeration date
06/06/2011
Last updated
04/01/2020
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