Individual
PRATIBHA RASTOGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13601 PRESTON RD, SUITE 1000 W, DALLAS, TX 75240-4911
(972) 715-5007
(972) 715-5682
Mailing address
PO BOX 660832, DALLAS, TX 75266-0832
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036081961
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360819616
—
IL
01
—
27-4170061
BCBS
IL
Enumeration date
10/25/2005
Last updated
04/16/2013
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