MEDICARE: VICKI WRIGHT

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	1041C0700X	Clinical Social Worker	29364	TX

General Provider Information

NPI Number	:	1881524874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI WRIGHT

Provider Business Mailing Address
First Line	:	15105 E RIDGE RD
Second Line	:
City	:	ARP
State	:	TX
Zip	:	75750-9780
Country	:	US
Telephone Number	:	903-520-0801
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 SAUNDERS AVE
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75702-7522
Country	:	US
Telephone Number	:	903-579-9861
Fax Number	:

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

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “ VICKI WRIGHT ” Practice Location

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