Healthcare Provider Details
I. General information
NPI: 1922126382
Provider Name (Legal Business Name): GLORIA S. WRIGHT, D.O., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2007
Last Update Date: 08/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17460 IH 35 N #420
SCHERTZ TX
78154-1264
US
IV. Provider business mailing address
17460 IH 35 N #420
SCHERTZ TX
78154-1264
US
V. Phone/Fax
- Phone: 210-654-9300
- Fax: 210-654-9302
- Phone: 210-654-9300
- Fax: 210-654-9302
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | K4613 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
GLORIA
SELVA
WRIGHT
Title or Position: PRESIDENT
Credential: D.O.
Phone: 210-654-9300