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General NPI Number Information
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NPI Number | 1457644866
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Entity Type | Organization
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Legal Business Name | MARK L. WRIGHT, M.D., P.A.
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 3316 CIRCLEWOOD CT
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City | GRAPEVINE
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State | TX
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Zip | 76051-6520
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Country | US
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Telephone | 817-283-8453
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 CIRCLEWOOD CT
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City | GRAPEVINE
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State | TX
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Zip | 76051-6520
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Country | US
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Telephone | 817-283-8453
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JILL BOETH
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Credential |
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Telephone | 682-237-7032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | H4810
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License Number State | TX
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