MEDICARE: MELISSA NEAL WRIGHT PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA01431	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00049547	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8N4425	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1215937651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA NEAL WRIGHT PA-C

Provider Business Mailing Address
First Line	:	1101 S MAIN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4802
Country	:	US
Telephone Number	:	817-321-4700
Fax Number	:	817-850-2372

Provider Business Practice Location Address
First Line	:	1101 S MAIN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4802
Country	:	US
Telephone Number	:	817-321-4700
Fax Number	:	817-850-2372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/25/2023

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Directions to “ MELISSA NEAL WRIGHT PA-C” Practice Location

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