Provider Demographics
NPI:1346608668
Name:WRIGHT, DOUGLAS MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:MARK
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DOUGLAS
Other - Middle Name:MARK
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2110 N CENTER ST
Mailing Address - Street 2:STE A
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-2628
Mailing Address - Country:US
Mailing Address - Phone:903-583-7574
Mailing Address - Fax:903-640-2067
Practice Address - Street 1:2110 N CENTER ST
Practice Address - Street 2:SUITE A
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-2628
Practice Address - Country:US
Practice Address - Phone:903-583-7574
Practice Address - Fax:903-640-2067
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor