Provider Demographics
NPI:1457536948
Name:IRA KRAUSE
Entity type:Organization
Organization Name:IRA KRAUSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-548-7713
Mailing Address - Street 1:8811 FM 1960 BYPASS RD W
Mailing Address - Street 2:300
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4023
Mailing Address - Country:US
Mailing Address - Phone:281-548-7713
Mailing Address - Fax:281-548-1414
Practice Address - Street 1:8811 FM 1960 BYPASS RD W
Practice Address - Street 2:300
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4023
Practice Address - Country:US
Practice Address - Phone:281-548-7713
Practice Address - Fax:281-548-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8184174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U5340OtherBLUE CROSS BLUE SHIELD