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NPI Code Detail

MEDICARE: MRS. MICHELLE MARIE WRIGHT PA-C, MMSC

MEDICARE:  MRS. MICHELLE MARIE WRIGHT  PA-C, MMSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA15876CA
2363AS0400XSurgical Physician AssistantPA04588TX

General Provider Information

NPI Number : 1700867637
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE MARIE WRIGHT PA-C, MMSC
Provider Business Mailing Address
First Line : 1505 ACACIA ST
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-5138
Country : US
Telephone Number : 214-729-4743
Fax Number :
Provider Business Practice Location Address
First Line : 4400 LONG PRAIRIE RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-1892
Country : US
Telephone Number : 214-729-4743
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 11/06/2019

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Directions to “ MRS. MICHELLE MARIE WRIGHT PA-C, MMSC” Practice Location

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