Provider Demographics
NPI:1578999256
Name:WRIGHT PEDIATRICS, PA
Entity Type:Organization
Organization Name:WRIGHT PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-582-7337
Mailing Address - Street 1:18924 FREEPORT DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-4589
Mailing Address - Country:US
Mailing Address - Phone:936-582-7337
Mailing Address - Fax:936-582-7338
Practice Address - Street 1:18924 FREEPORT DR
Practice Address - Street 2:SUITE B
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-4589
Practice Address - Country:US
Practice Address - Phone:936-582-7337
Practice Address - Fax:936-582-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4211, N4851208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1184818585OtherNPI TYPE 1
TX1114906989OtherNPI TYPE 1