Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | BP10063478 | TX |
NPI | 1013414176 |
---|---|
Provider Name | Meghan Drake |
First Address | Dallas, TX 75203-1201 |
Second Address | Dallas, TX 75203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2018 |
Last Update Date | 04/06/2018 |