Provider Demographics
NPI:1568916997
Name:WRIGHT, TERRI LEAANN (SLP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LEAANN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:LEAANN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1201 S IH 35
Mailing Address - Street 2:STE.105
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6615
Mailing Address - Country:US
Mailing Address - Phone:512-310-7665
Mailing Address - Fax:512-310-9228
Practice Address - Street 1:1201 S IH 35
Practice Address - Street 2:STE.105
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6615
Practice Address - Country:US
Practice Address - Phone:512-310-7665
Practice Address - Fax:512-310-9228
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094474602Medicaid
TX456890Medicare Oscar/Certification