Healthcare Provider Details
I. General information
NPI: 1720065774
Provider Name (Legal Business Name): TERESA SEXAUER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/29/2005
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
455 SHERMAN SUITE 510
DENVER CO
80203-4405
US
IV. Provider business mailing address
455 SHERMAN ST STE 510
DENVER CO
80203-4400
US
V. Phone/Fax
- Phone: 303-377-6825
- Fax: 303-780-0787
- Phone: 303-377-6825
- Fax: 303-780-0787
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 33590 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: