Provider Demographics
NPI:1609120997
Name:WRIGHT, LISA (PT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BUSBY RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8013
Mailing Address - Country:US
Mailing Address - Phone:830-230-5222
Mailing Address - Fax:
Practice Address - Street 1:711 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1623
Practice Address - Country:US
Practice Address - Phone:830-816-5453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1125128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist