Provider Demographics
NPI:1902981046
Name:WRIGHT, TIMOTHY ANDREW (OD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ANDREW
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6302
Mailing Address - Country:US
Mailing Address - Phone:972-424-6010
Mailing Address - Fax:972-424-9913
Practice Address - Street 1:1410 14TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6302
Practice Address - Country:US
Practice Address - Phone:972-424-6010
Practice Address - Fax:972-424-9913
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5473TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU74202Medicare UPIN
TX00520PMedicare ID - Type Unspecified