Provider Demographics
NPI:1003959057
Name:WRIGHT, CAROLYN JEANETTE (NP)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JEANETTE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:C.
Other - Middle Name:JEANNETTE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:9410 SUNPERCH CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2886
Mailing Address - Country:US
Mailing Address - Phone:281-412-3912
Mailing Address - Fax:
Practice Address - Street 1:921 GESSNER
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-242-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX604423363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86N906OtherBLUE CROSS BLUE SHIELD
TX86N906OtherBLUE CROSS BLUE SHIELD
TX8G1207Medicare ID - Type Unspecified