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General NPI Number Information
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NPI Number | 1801522040
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Entity Type | Individual
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Provider Name | MATARA WRIGHT
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2800 S MACGREGOR WAY
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City | HOUSTON
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State | TX
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Zip | 77021-1032
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Country | US
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Telephone | 713-500-1838
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 N POST OAK RD APT 5212
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City | HOUSTON
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State | TX
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Zip | 77055-7344
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.010227
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 39384
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License Number State | TX
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