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General NPI Number Information
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NPI Number | 1700867637
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Entity Type | Individual
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Provider Name | MICHELLE MARIE WRIGHT PA-C, MMSC
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 4400 LONG PRAIRIE RD
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1892
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Country | US
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Telephone | 214-729-4743
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 ACACIA ST
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City | FLOWER MOUND
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State | TX
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Zip | 75028-5138
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Country | US
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Telephone | 214-729-4743
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA15876
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA04588
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License Number State | TX
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