Provider Demographics
NPI:1861038788
Name:WRIGHT, CHRISTIAN EDWARD
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:EDWARD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 SAYLES BLVD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-3202
Mailing Address - Country:US
Mailing Address - Phone:405-471-4153
Mailing Address - Fax:
Practice Address - Street 1:842 SAYLES BLVD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-3202
Practice Address - Country:US
Practice Address - Phone:405-471-4153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-19-106276106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician