Provider Demographics
NPI:1831534536
Name:R PRATURI PLLC
Entity type:Organization
Organization Name:R PRATURI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJASREE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-654-1982
Mailing Address - Street 1:2374 BRONZE OAK LN
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-4093
Mailing Address - Country:US
Mailing Address - Phone:770-654-1982
Mailing Address - Fax:404-292-3848
Practice Address - Street 1:465 WINN WAY STE 221
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1723
Practice Address - Country:US
Practice Address - Phone:404-292-3810
Practice Address - Fax:404-292-3848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0499352084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty