Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 14417 | TX |
NPI | 1043818792 |
---|---|
Provider Name | Leonard Charles Wright |
First Address | Dallas, TX 75220-1216 |
Second Address | Dallas, TX 75220-1216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2020 |
Last Update Date | 14/10/2020 |