Provider Demographics
NPI:1073157822
Name:WRIGHT, SHAYNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SHAYNE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:SHAYNE
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SHAYNE WRIGHT, DPT
Mailing Address - Street 1:7 LOOKOUT CT
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2064
Mailing Address - Country:US
Mailing Address - Phone:903-235-5468
Mailing Address - Fax:
Practice Address - Street 1:2903 JUDSON RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-1803
Practice Address - Country:US
Practice Address - Phone:903-235-5468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic