Provider Demographics
NPI:1487779864
Name:WRIGHT FAMILY PRACTICE
Entity type:Organization
Organization Name:WRIGHT FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LICERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-296-7888
Mailing Address - Street 1:2606 YONKERS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-1851
Mailing Address - Country:US
Mailing Address - Phone:806-296-7888
Mailing Address - Fax:806-296-7888
Practice Address - Street 1:2606 YONKERS ST STE 1
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1851
Practice Address - Country:US
Practice Address - Phone:806-296-7888
Practice Address - Fax:806-296-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty