DR. GLEN B. DRAKE (NPI# 1871553685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871553685 |
| Entity Type | Individual |
| Full Name | DR. GLEN B. DRAKE |
| Credential | M.D. |
| Practice Address |
2401 S 31st St Temple TX 76508-0001 |
| Mailing Address |
Po Box 847408 Dallas TX 75284-7408 |
| Practice Telephone | 2547242111 |
| Mailing Telephone | 2547242111 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2007-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
E4305 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE SHIELD | 807460 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790815876 | Glen S Drake | Marriage & Family Therapist | 118 N 7th St Ste C13, Coeur D Alene, ID 83814 | 2007-03-06 |
| Street Address |
2401 S 31ST ST |
| City | TEMPLE |
| State | TX |
| Zip Code | 76508-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487650651 | Kathleen G Halka | Internal Medicine | 2401 S 31st St, Temple, TX 76508 | 2005-06-22 |
| 1720689060 | Christy Evans | Pharmacist | 2401 S 31st St, Temple, TX 76508-0001 | 2020-11-03 |
| 1588264683 | Giuseppe Tavilla | Surgery | 2401 S 31st St, Temple, TX 76508-0001 | 2020-10-28 |
| 1942809884 | Crystal Das | Student in an Organized Health Care Education/Training Program | 2401 S 31st St, Temple, TX 76508-0001 | 2020-10-21 |
| 1730795766 | Joshua R Ledezma | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2020-09-15 |
| 1437762069 | Caroline Stanley | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2020-08-24 |
| 1841809191 | Deanette James | Registered Nurse | 2401 S 31st St, Temple, TX 76508-0001 | 2020-07-23 |
| 1285259309 | Amanda Lea Johnson | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2020-06-15 |
| 1013539758 | Brittany Ellis | Physical Therapist | 2401 S 31st St, Temple, TX 76508-0001 | 2020-05-15 |
| 1114549508 | Matthew Marvin Galland | Pharmacist | 2401 S 31st St, Temple, TX 76508-0001 | 2020-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619596491 | Samuel Adrian Matthys | Student in an Organized Health Care Education/Training Program | 2401 South 31st St, Ms-ag-407q, Temple, TX 76508 | 2020-04-13 |
| 1700414968 | Darshan Patel | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street, Ms-ck-300-kessiah Foster, Temple, TX 76508 | 2020-03-31 |
| 1992332134 | Kiersi Harmon | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street Ms-ag-303h, Baylor Scott & White Medical Center-temple, Temple, TX 76508 | 2020-03-26 |
| 1053948851 | Christian Beltran | Student in an Organized Health Care Education/Training Program | 2410 South 31st Street, Ms 01 161b, Temple, TX 76508 | 2020-03-24 |
| 1790311850 | Chinyere Ashley Onyirimba | Student in an Organized Health Care Education/Training Program | Baylor Scott & White Medical Center - Temple, 2401 South 31st Street, Ms-ag-303h, Temple, TX 76508 | 2020-03-19 |
| 1578022398 | Kedric Glenn | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street, Ms-11-ag062, Temple, TX 76508 | 2019-03-19 |
| 1518426592 | Muhammad Imran Bhatti | Student in an Organized Health Care Education/Training Program | Baylor Scott and White Medical Center-temple 2401, South 31st Street Ms-01-161b, Temple, TX 76508 | 2019-03-18 |
| 1780143883 | Nathaniel Clayton Palmer | Student in an Organized Health Care Education/Training Program | 2401 South 31st Street, Ms-s2-663 Temple, Texas 76508, Temple, TX 76508 | 2019-03-18 |
| 1235620741 | Fahmida Musharof | Student in an Organized Health Care Education/Training Program | 2401 S 31st Street, Ms-ck-300, Temple, TX 76508 | 2018-05-21 |
| 1275038325 | Robert Casey Alan Finch | Student in an Organized Health Care Education/Training Program | 2401 S 31st St, Ms-ck-300, Temple, TX 76508 | 2018-03-29 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972731644 | Cardiovascular Sepcialists of Texas, P.a. | Internal Medicine | 1905 Sw H.k. Dodgen Loop, Temple, TX 76502-1814 | 2009-07-01 |
| 1396724373 | Peter Yuk Cheung | Internal Medicine | 2401 South 31st Street, Temple, TX 75608 | 2006-01-10 |
| 1336533397 | Alireza Movahed | Internal Medicine | 2401 S 31st St, Temple, TX 76508-0001 | 2015-03-26 |
| 1467862573 | Clinton Joseph Thurber | Internal Medicine | 2401 S 31st St, Temple, TX 76508-0001 | 2014-04-29 |
| 1962847947 | Joseph Albright Stafford | Internal Medicine | 2401 S 31st St, Temple, TX 76508-0001 | 2013-05-06 |
| 1477795516 | Salman Gohar | Internal Medicine | 2401 S 31st St, Temple, TX 76508 | 2009-04-06 |
| 1104074541 | Texas Cardiovascular Consultants, Pa | Internal Medicine | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2008-08-27 |
| 1053524827 | Javier Banchs | Internal Medicine | 2401 S 31st St, Temple, TX 76508-0001 | 2007-05-08 |
| 1548351042 | Rajiv Gupta | Internal Medicine | 1901 S 1st St, Temple, TX 76504-7451 | 2006-09-28 |
| 1356353528 | Rajendra P Motaparthi | Internal Medicine | 1901 S 1st St, Va Hospital, Temple, TX 76504-7451 | 2006-08-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.