Provider Demographics
NPI:1790889954
Name:WRIGHT, DARREL KEITH JR (THM PHD)
Entity Type:Individual
Prefix:DR
First Name:DARREL
Middle Name:KEITH
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:THM PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7557 RAMBLER
Mailing Address - Street 2:SUITE 750
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-265-6554
Mailing Address - Fax:214-265-6501
Practice Address - Street 1:7557 RAMBLER
Practice Address - Street 2:SUITE 750
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-265-6554
Practice Address - Fax:214-265-6501
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24290103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
K0SHMedicare ID - Type Unspecified