Provider Demographics
NPI:1669765855
Name:WRIGHT, ROBERT (MS, CCC/A)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N COMMONS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7940
Mailing Address - Country:US
Mailing Address - Phone:331-229-8335
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:6348 EDGEMERE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3517
Practice Address - Country:US
Practice Address - Phone:915-774-9987
Practice Address - Fax:915-774-9681
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51036231H00000X, 237600000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB129112Medicare PIN