Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1170390 | TX |
NPI | 1003136169 |
---|---|
Provider Name | Mr. Randy L Wright |
First Address | Mcallen, TX 78501-2920 |
Second Address | Mcallen, TX 78501-2920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2010 |
Last Update Date | 21/08/2018 |