Drake, Terrisa Jo
Drake, Terrisa Jo is an sole proprietor health care provider with primary practice located at 1706 Sw Loop 410 Ste 101 , San Antonio TX 78227-1676. She recently has 7 registered licenses in different health care specialties including Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision, Allopathic & Osteopathic Physicians / Glaucoma Specialist, Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Drake, Terrisa Jo can be contacted via phone (726) 999-3632.Contact Information
Primary practice address
1706 Sw Loop 410 Ste 101
San Antonio TX 78227-1676
Phone: (726) 999-3632
Fax: (726) 999-3633
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 5817TG | Texas |
Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 5817TG | Texas |
Allopathic & Osteopathic Physicians / Glaucoma Specialist | 207WX0009X | 5817TG | Texas |
Eye and Vision Services Providers / Optometrist | 152W00000X | 5817TG | Texas |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 5817TG | Texas |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 5817TG | Texas |
Eye and Vision Services Providers / Sports Vision | 152WS0006X | 5817TG | Texas |
Profile Details
NPI number | 1134275761 |
---|---|
LBN Legal business name | Drake, Terrisa Jo |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 26th, 2007 |
Last updated | Feb 19th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1134275761 | NPPES |
Texas | Other | 488959ZUNK | MEDICARE GROUP MEMBER PROVIDER NUMBER |
Texas | MEDICAID | 1134275761 | MEDICARE GROUP MEMBER PROVIDER NUMBER |
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