Provider Demographics
NPI:1356667554
Name:KRAUSE, TERRY SIRIPHATNABOON (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:SIRIPHATNABOON
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:TIPANAN
Other - Last Name:SIRIPHATNABOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9135 RIDGELINE BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2391
Mailing Address - Country:US
Mailing Address - Phone:303-649-3140
Mailing Address - Fax:303-649-3154
Practice Address - Street 1:9475 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7802
Practice Address - Country:US
Practice Address - Phone:303-470-4071
Practice Address - Fax:303-470-4072
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine