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General NPI Number Information
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NPI Number | 1891512505
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Entity Type | Organization
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Legal Business Name | RESTORA HEALTH PLLC
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 555 REPUBLIC DR STE 100B
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City | PLANO
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State | TX
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Zip | 75074-5481
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Country | US
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Telephone | 972-308-0000
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Fax | 972-318-2003
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Provider Business Mailing Address
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Address Line | 555 REPUBLIC DR STE 100B
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City | PLANO
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State | TX
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Zip | 75074-5481
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Country | US
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Telephone | 972-308-0000
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Fax | 972-318-2003
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Authorized Official
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Title or Position | CEO/OWNER
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Name | RABEEA K CHOUDHARY
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Credential | MD
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Telephone | 972-308-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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