Provider Demographics
NPI:1073556957
Name:STOWERS WRIGHT, LORI ELLEN (PHD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ELLEN
Last Name:STOWERS WRIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ELLEN
Other - Last Name:CARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5524 BEE CAVES RD STE K4
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5247
Mailing Address - Country:US
Mailing Address - Phone:512-649-3050
Mailing Address - Fax:512-717-6337
Practice Address - Street 1:12012 WICKCHESTER LN
Practice Address - Street 2:SUITE 550
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1229
Practice Address - Country:US
Practice Address - Phone:832-448-2800
Practice Address - Fax:832-448-2801
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32266103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162335701Medicaid
TX162335702Medicaid
TX86855AOtherBCBS
TX8B2894Medicare ID - Type Unspecified