Provider Demographics
NPI:1295758548
Name:WRIGHT, DEEDRA (FNP)
Entity type:Individual
Prefix:
First Name:DEEDRA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:DEEDRA
Other - Middle Name:A
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 UNIVERSITY DR E
Practice Address - Street 2:ENTRANCE 16 FL 2 DESK S SIDE B
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-2661
Practice Address - Country:US
Practice Address - Phone:979-361-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP114676363LF0000X, 363LA2200X
TX666753363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y1719OtherBCBS TX
TX182426003Medicaid
TXP00466548OtherRR MEDICARE
1992722953OtherSCOTT & WHITE HEALTH PLAN
TX182426003Medicaid
TXP00466548Medicare PIN
TX8J4224Medicare PIN