Basic Information
| Provider Information | |||||||||
| NPI: | 1225174576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | MANDY | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1350 ASHBY ST STE B | ||||||||
| Address2: | |||||||||
| City: | SEGUIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781555154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8303039400 | ||||||||
| FaxNumber: | 8303039420 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 PERSON STREET | ||||||||
| Address2: | |||||||||
| City: | STOCKDALE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8309963701 | ||||||||
| FaxNumber: | 8309963749 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 08/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 634624 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | AP110180 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.