Trinity Diagnostic Clinic, P.a

Primary specialty

Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X

License

G7866 Issued in TX

Legal business name

TRINITY DIAGNOSTIC CLINIC, P.A

Practice address

6324 Southern Hills Dr
Fort Worth, TX 76132-4485

Phone

(817) 905-2254

NPI assigned

Jun 3, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kosuri B Raju, M.D.

Title

President

Phone

(817) 905-2254

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Trinity Diagnostic Clinic PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Trinity Diagnostic Clinic, PA

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1801154125
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1508214222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 SOUTHERN HILLS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-905-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 SOUTHERN HILLS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324485",
            "telephone_number": "817-905-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY DIAGNOSTIC CLINIC, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "KOSURI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-905-2254",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "G7866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123216705",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khai Trinh
• Lan Quynh Trinh, PA-C
• Ngoc Trinh, PHARM.D.
• Phung Trinh, PHARMD
• Trinity Anesthesia Professionals, PLLC
• Trinity Diagnostic Clinic, PA
• Trinity Foot & Ankle Specialists, PLLC
• Trinity Hospice- Castle Peak, LP
• Trinity Infusion Services, Inc.
• Trinity MD LLC

• Medicare Defined Swing Bed Hospital Unit in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Medicare Defined Swing Bed Hospital Unit in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.