Provider Demographics
NPI:1942220041
Name:WRIGHT, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
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 1:7003 WOODWAY DR
Mailing Address - Street 2:STE 303
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6170
Mailing Address - Country:US
Mailing Address - Phone:254-741-1711
Mailing Address - Fax:254-741-6998
Practice Address - Street 1:7003 WOODWAY DR
Practice Address - Street 2:STE 303
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6170
Practice Address - Country:US
Practice Address - Phone:254-741-1711
Practice Address - Fax:254-741-6998
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD33405Medicare UPIN