Provider Demographics
NPI:1417946385
Name:KRAPU, THOMAS M (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:KRAPU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 EXECUTIVE PARKWAY DR
Mailing Address - Street 2:STE 8
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6323
Mailing Address - Country:US
Mailing Address - Phone:314-842-2258
Mailing Address - Fax:866-503-5305
Practice Address - Street 1:1023 EXECUTIVE PARKWAY DR
Practice Address - Street 2:STE 8
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6323
Practice Address - Country:US
Practice Address - Phone:314-842-2258
Practice Address - Fax:866-503-5305
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPYR-0163103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO70240Medicare ID - Type Unspecified