Provider Demographics
NPI:1700348901
Name:DEEDRA WRIGHT, DC, PLLC
Entity Type:Organization
Organization Name:DEEDRA WRIGHT, DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-721-6288
Mailing Address - Street 1:1125 FM 1230
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:TX
Mailing Address - Zip Code:79545-3313
Mailing Address - Country:US
Mailing Address - Phone:325-721-6288
Mailing Address - Fax:
Practice Address - Street 1:1125 FM 1230
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:TX
Practice Address - Zip Code:79545-3313
Practice Address - Country:US
Practice Address - Phone:325-721-6288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty