Provider Demographics
NPI:1922068220
Name:WRIGHT, TERRY (DPM)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 RACE ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-4116
Mailing Address - Country:US
Mailing Address - Phone:817-838-9424
Mailing Address - Fax:817-838-9425
Practice Address - Street 1:3020 RACE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-4116
Practice Address - Country:US
Practice Address - Phone:817-838-9424
Practice Address - Fax:817-838-9425
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1197213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L52AOtherBLUE CROSS BLUE SHIELD
TX752437647OtherCIGNA
TX2157365OtherAETNA HMO
TX27417664OtherTRICARE/HUMMANA
TX752437647OtherUNITED HEALTHCARE
TXP00848935OtherRAIL ROAD MEDICARE
TX127204903Medicaid
TX752437647OtherPHCS
TX752347647OtherPACIFICARE/SECURE HORIZON
TX4357248OtherAETNA PPO
TX752437647OtherCIGNA
TX752437647OtherPHCS
TX127204903Medicaid