Provider Demographics
NPI:1093731747
Name:DRAKE, NATALIE L (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:L
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:L
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6700 WOODLANDS PKWY STE 230-151
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2575
Mailing Address - Country:US
Mailing Address - Phone:281-203-5115
Mailing Address - Fax:281-203-5119
Practice Address - Street 1:17350 ST LUKES WAY STE 350
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4103
Practice Address - Country:US
Practice Address - Phone:281-203-5115
Practice Address - Fax:281-203-5119
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0256207VG0400X, 207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2696355Medicaid
OH2696355Medicaid
H60426Medicare UPIN
OH7358011Medicare PIN