Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 121394 | OH |
Y | 2080P0210X | Pediatric Nephrologist | R3315 | TX |
NPI | 1629396858 |
---|---|
Provider Name | Dr. Keri Anne Drake |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2010 |
Last Update Date | 07/08/2017 |