Provider Demographics
NPI:1659110237
Name:WRIGHT, NICOLE A (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 WOODSTEAD CT STE 300
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1449
Mailing Address - Country:US
Mailing Address - Phone:281-374-2273
Mailing Address - Fax:
Practice Address - Street 1:1441 WOODSTEAD CT STE 300
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1449
Practice Address - Country:US
Practice Address - Phone:281-374-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical