MEDICARE: KELLI THOMAS-DRAKE PBT, BA, MS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician	C7Y7F4A7	TX

General Provider Information

NPI Number	:	1144153545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI THOMAS-DRAKE PBT, BA, MS, MS

Provider Business Mailing Address
First Line	:	7610 SWEETGUM DR
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-3460
Country	:	US
Telephone Number	:	469-261-5250
Fax Number	:

Provider Business Practice Location Address
First Line	:	7610 SWEETGUM DR
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-3460
Country	:	US
Telephone Number	:	469-261-5250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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