Healthcare Provider Details

I. General information

NPI: 1669765855
Provider Name (Legal Business Name): ROBERT WRIGHT M.S., CCC/A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 03/26/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6348 EDGEMERE BLVD
EL PASO TX
79925-3517
US

IV. Provider business mailing address

750 N COMMONS DR STE 200
AURORA IL
60504-7940
US

V. Phone/Fax

Practice location:
  • Phone: 915-774-9987
  • Fax: 915-774-9681
Mailing address:
  • Phone: 331-229-8335
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number51036
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number51036
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: