Provider Demographics
NPI:1447889175
Name:CHAUDHRY, RABAIL
Entity type:Individual
Prefix:
First Name:RABAIL
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 E AVENIDA DEL CAZADOR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-7244
Mailing Address - Country:US
Mailing Address - Phone:832-812-9689
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE RM 4401
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-7221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-04
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ64264207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty