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Individual

VIRGINIA R DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RVT, RT, LVN

Contact information

Practice address
2718A N MAIN ST, LIBERTY, TX 77575-3909
(936) 336-3616
Mailing address
PO BOX 222, LIBERTY, TX 77575-0222
(936) 336-3616

Taxonomy

Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
115278
TX

Other

Enumeration date
09/08/2006
Last updated
07/08/2007
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