Organization
DR TERRISA DRAKE OD PA
Active
Other names
Premier Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRISA J DRAKE O.D. (OPTOMETRIST)
(806) 535-7052
Entity
Organization
Contact information
Practice address
4215 S LOOP 289, LUBBOCK, TX 79423-1100
(806) 535-7052
Mailing address
4215 S LOOP 289, LUBBOCK, TX 79423-1100
(806) 535-7052
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5817TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019142101
—
TX
Enumeration date
12/12/2015
Last updated
12/12/2015
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