Provider Demographics
NPI:1003136169
Name:WRIGHT, RANDY L (MPT)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2920
Mailing Address - Country:US
Mailing Address - Phone:956-994-0011
Mailing Address - Fax:956-994-0449
Practice Address - Street 1:232 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2920
Practice Address - Country:US
Practice Address - Phone:956-994-0011
Practice Address - Fax:956-994-0449
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist