Trinity Diagnostic Clinic, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TRINITY DIAGNOSTIC CLINIC, PA

Practice address

909 9TH Ave
Suite 405
Fort Worth, TX 76104-3903

Phone

(817) 332-2009

Fax

(817) 877-0122

NPI assigned

Apr 24, 2012

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, MD

Title

Owner

Phone

(817) 332-2009

Specialties & licenses 1

Addresses

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, P.a

  • Medicare Defined Swing Bed Hospital Unit
  • Fort Worth, TX
  • NPI 1508214222
  NPD tax ID

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1801154125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33908",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761623908",
            "telephone_number": "817-332-2009",
            "fax_number": "817-877-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 9TH AVE",
            "address_2": "SUITE 405",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043903",
            "telephone_number": "817-332-2009",
            "fax_number": "817-877-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY DIAGNOSTIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "KOSURI",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-332-2009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• Internal Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.