Basic Information
| Provider Information | |||||||||
| NPI: | 1831534536 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | R PRATURI PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2374 BRONZE OAK LN | ||||||||
| Address2: | |||||||||
| City: | BRASELTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305174093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706541982 | ||||||||
| FaxNumber: | 4042923848 | ||||||||
| Practice Location | |||||||||
| Address1: | 465 WINN WAY STE 221 | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300301723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042923810 | ||||||||
| FaxNumber: | 4042923848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2013 | ||||||||
| LastUpdateDate: | 05/19/2016 | ||||||||
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| AuthorizedOfficialLastName: | PRATURI | ||||||||
| AuthorizedOfficialFirstName: | RAJASREE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7706541982 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084B0040X | 049935 | GA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry |
No ID Information.