MEDICARE: LISA MARIE WRIGHT P.A

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
1	363A00000X	Physician Assistant	PA06814	TX

General Provider Information

NPI Number	:	1801109848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MARIE WRIGHT P.A

Provider Business Mailing Address
First Line	:	PO BOX 587
Second Line	:
City	:	GONZALES
State	:	TX
Zip	:	78629-0587
Country	:	US
Telephone Number	:	830-672-8502
Fax Number	:	830-672-3035

Provider Business Practice Location Address
First Line	:	1300 CAPTAIN ALBERT MARTIN TRAIL
Second Line	:
City	:	GONZALES
State	:	TX
Zip	:	78629
Country	:	US
Telephone Number	:	830-672-8502
Fax Number	:	830-672-3035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	05/11/2026

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