Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 6508 | TX |
NPI | 1326043951 |
---|---|
Provider Name | Robert Wright |
First Address | Midlothian, TX 76065-3340 |
Second Address | Midlothian, TX 76065-3340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 16/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U2270 | (02) | TX |