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Individual

OTIS D WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
7005 MIRA LOMA LN, SUITE 102, AUSTIN, TX 78723-1411
(512) 795-4344
(512) 928-9466
Mailing address
7005 MIRA LOMA LN, SUITE 102, AUSTIN, TX 78723-1411
(512) 795-4344
(512) 928-9466

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP115175
TX
363LG0600X
Gerontology Nurse Practitioner
NP 16852
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP115175
NP LICENSE
TX
01
NP16852
NP LICENSE
CA
Enumeration date
10/20/2006
Last updated
01/31/2017
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