Provider Demographics
NPI:1902588155
Name:WRIGHT, BRANDON (CPT)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 HIDDEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-4604
Mailing Address - Country:US
Mailing Address - Phone:254-624-4039
Mailing Address - Fax:
Practice Address - Street 1:1301 MEDICAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2529
Practice Address - Country:US
Practice Address - Phone:254-624-4039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23-1842246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty