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NPI 1922068220

NPI 1922068220 : TERRY WRIGHT DPM : FORT WORTH, TX

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General NPI Number Information
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    NPI Number           |    1922068220
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    Entity Type          |    Individual 
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    Provider Name        |    TERRY WRIGHT DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/23/2006
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    Last Update Date     |    12/29/2011
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Provider Practice Location Address
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    Address Line         |    3020 RACE ST 
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    City                 |    FORT WORTH
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    State                |    TX
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    Zip                  |    76111-4116
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    Country              |    US
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    Telephone            |    817-838-9424
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    Fax                  |    817-838-9425
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Provider Business Mailing Address
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    Address Line         |    3020 RACE ST 
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    City                 |    FORT WORTH
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    State                |    TX
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    Zip                  |    76111-4116
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    Country              |    US
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    Telephone            |    817-838-9424
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    Fax                  |    817-838-9425
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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        |    213ES0131X
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    Taxonomy Name        |    Foot Surgery Podiatrist
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    License Number       |    1197
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    License Number State |    TX
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