Healthcare Provider Details

I. General information

NPI: 1083671275
Provider Name (Legal Business Name): STEPHEN EDGAR WRIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 AMARILLO BLVD WEST
AMARILLO TX
79106
US

IV. Provider business mailing address

6010 AMARILLO BLVD WEST
AMARILLO TX
79106
US

V. Phone/Fax

Practice location:
  • Phone: 806-354-7871
  • Fax: 806-468-1863
Mailing address:
  • Phone: 806-354-7871
  • Fax: 806-468-1863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberC4157
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: