Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 35088120 | OH |
Y | 207VX0201X | Gynecologic Oncologist | L5310 | TX |
NPI | 1306866413 |
---|---|
Provider Name | Dr. Richard Drake |
First Address | The Woodlands, TX 77382-2575 |
Second Address | The Woodlands, TX 77384-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 28/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
152343303 | (05) | TX |
152343304 | (05) | TX |
P01178728 | RAILROAD MEDICARE (01) | VA |