Individual
DALLAS GLEN WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6901 MEDICAL PKWY, WACO, TX 76712
(254) 751-4242
(254) 751-4243
Mailing address
3105 SKINNER DR, LORENA, TX 76655-3239
(804) 358-7488
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
BP1OO57711
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
S3092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
842047
MEDICARE
TX
Enumeration date
06/06/2016
Last updated
09/09/2019
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