Provider Demographics
NPI:1003408840
Name:ATTALURI, RAJESWARI (RPH)
Entity Type:Individual
Prefix:
First Name:RAJESWARI
Middle Name:
Last Name:ATTALURI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75132-0727
Mailing Address - Country:US
Mailing Address - Phone:972-499-5044
Mailing Address - Fax:972-584-9558
Practice Address - Street 1:109 E FATE MAIN PL
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75087-6962
Practice Address - Country:US
Practice Address - Phone:972-499-5044
Practice Address - Fax:972-584-9558
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist