Healthcare Provider Details

I. General information

NPI: 1104089382
Provider Name (Legal Business Name): LAXMI A. KONDAPALLI MD, MSCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 HALE PKWY STE 490
DENVER CO
80220-4013
US

IV. Provider business mailing address

10290 RIDGEGATE CIR
LONE TREE CO
80124-5331
US

V. Phone/Fax

Practice location:
  • Phone: 303-355-2555
  • Fax:
Mailing address:
  • Phone: 303-788-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number50363
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: