OTIS D WRIGHT NP NPI 1104909688

NPI Information

NPI: 1104909688
Provider Name: OTIS D WRIGHT, NP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
7005 MIRA LOMA LN
SUITE 102
AUSTIN, TX
ZIP 78723
Phone: (512) 795-4344
Get Directions

Otis D Wright, NP is a gerontology nurse practitioner in Austin, TX with 18 years of experience. Otis D Wright, NP NPI is 1104909688. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year:2006

The provider's business location address is:

7005 MIRA LOMA LN
SUITE 102
AUSTIN, TX
ZIP 78723-411
Phone: (512) 795-4344
Fax: (512) 928-9466

The NPI 1104909688 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 1/31/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	AP115175	TEXAS	Yes
2	363LG0600X	Nurse Practitioner	Gerontology	NP 16852	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP16852	OTHER	CALIFORNIA	NP LICENSE
2	AP115175	OTHER	TEXAS	NP LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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