Provider Demographics
NPI:1831931138
Name:WRIGHT, MADISON ANN LOUISE (DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ANN LOUISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SHORE DISTRICT DR APT 2413
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1334
Mailing Address - Country:US
Mailing Address - Phone:509-954-0707
Mailing Address - Fax:
Practice Address - Street 1:12411 HYMEADOW DR BLDG 3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1874
Practice Address - Country:US
Practice Address - Phone:512-335-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1391853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist