Individual
PATRICIA D DRAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2990 N BROADWAY AVE, TYLER, TX 75702-2149
(903) 593-1892
Mailing address
PO BOX 844273, DALLAS, TX 75284-4273
(903) 535-9041
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
592323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101388001
—
TX
05
—
101388003
—
TX
05
—
101388004
—
TX
05
—
101388005
—
TX
01
—
45-2578435
TRICARE
TX
01
—
592323
RN LICENSE
TX
01
—
80N282
BCBS
TX
01
—
883N41
BCBS
TX
Enumeration date
10/19/2006
Last updated
12/16/2014
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