Provider Demographics
NPI:1184631947
Name:WRIGHT, JASON MAYFIELD (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:MAYFIELD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-4809
Mailing Address - Country:US
Mailing Address - Phone:806-244-9251
Mailing Address - Fax:
Practice Address - Street 1:1411 DENVER AVE
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022-4809
Practice Address - Country:US
Practice Address - Phone:806-244-9251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05132363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186026401Medicaid
TX8Y1716OtherBCBS
TX8Y1573OtherBCBS
TX186026402Medicaid
TX8Y3421OtherBCBS
TX8Y1716OtherBCBS
TX186026402Medicaid
TX8J5624Medicare PIN