Provider Demographics
NPI:1003077504
Name:WRIGHT, ANNE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 HAMILTON WOLFE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3456
Mailing Address - Country:US
Mailing Address - Phone:210-616-0283
Mailing Address - Fax:210-616-0071
Practice Address - Street 1:4775 HAMILTON WOLFE RD STE 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3456
Practice Address - Country:US
Practice Address - Phone:210-616-0283
Practice Address - Fax:210-616-0071
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218706401Medicaid
TXTXB115514Medicare UPIN