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General NPI Number Information
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NPI Number | 1093796534
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Entity Type | Individual
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Provider Name | NATHAN J WRIGHT M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 2014 GALLERIA OAKS DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4620
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Country | US
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Telephone | 903-792-2991
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Fax | 903-792-2995
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Provider Business Mailing Address
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Address Line | 5002 COWHORN CREEK RD
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City | TEXARKANA
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State | TX
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Zip | 75503-9766
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Country | US
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Telephone | 903-614-3000
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Fax | 903-614-3525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J8422
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C8316
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License Number State | AR
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