Provider Demographics
NPI:1619129657
Name:WRIGHT, DANIEL D (LSA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 N MAIN ST APT 3318
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2773
Mailing Address - Country:US
Mailing Address - Phone:817-800-1163
Mailing Address - Fax:
Practice Address - Street 1:751 N MAIN ST APT 3318
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2773
Practice Address - Country:US
Practice Address - Phone:817-800-1163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCSFA171007246ZC0007X
TXSA00817246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant