Provider Demographics
NPI:1851492060
Name:WRIGHT, EARL PAT (MD)
Entity Type:Individual
Prefix:MR
First Name:EARL
Middle Name:PAT
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 693
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791
Mailing Address - Country:US
Mailing Address - Phone:903-871-2132
Mailing Address - Fax:903-871-2333
Practice Address - Street 1:15632 HWY 110 SOUTH
Practice Address - Street 2:SUITE 19
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791
Practice Address - Country:US
Practice Address - Phone:903-871-2132
Practice Address - Fax:903-871-2333
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1362642-01Medicaid
TX00541GMedicare ID - Type Unspecified
TXE18169Medicare UPIN