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General NPI Number Information
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NPI Number | 1861997579
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Entity Type | Individual
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Provider Name | DRAKE GLENN LEBRUN
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 22751 PROFESSIONAL DR STE 250
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City | KINGWOOD
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State | TX
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Zip | 77339-6028
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Country | US
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Telephone | 281-668-7205
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-4509
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Country | US
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Telephone | 713-799-2300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | V1526
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | V1526
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License Number State | TX
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