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Individual

MR. ROBERT M WRIGHT III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.P.O.

Contact information

Practice address
812 N 4TH ST, LONGVIEW, TX 75601-5413
(903) 236-4488
(903) 236-4607
Mailing address
812 N 4TH ST, LONGVIEW, TX 75601-5413
(903) 236-4488
(903) 236-4607

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
106
TX
224P00000X
Prosthetist
Primary
106
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
519698
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/14/2005
Last updated
12/10/2007
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