Healthcare Provider Details

I. General information

NPI: 1396509543
Provider Name (Legal Business Name): ZOIE DRAKE IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZOIE WILLIAMSON

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 BROADWAY ST
PEARLAND TX
77581-5501
US

IV. Provider business mailing address

8311 BRAESDALE LN
HOUSTON TX
77071-1227
US

V. Phone/Fax

Practice location:
  • Phone: 281-485-9990
  • Fax:
Mailing address:
  • Phone: 214-927-6115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-314292
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: