Provider Demographics
NPI:1700082419
Name:WRIGHT, RAQUEL PACHECO (DMD)
Entity type:Individual
Prefix:DR
First Name:RAQUEL
Middle Name:PACHECO
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1168
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1168
Mailing Address - Country:US
Mailing Address - Phone:256-241-7340
Mailing Address - Fax:256-241-7373
Practice Address - Street 1:3910 GASTON AVE STE 175
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1504
Practice Address - Country:US
Practice Address - Phone:214-257-1082
Practice Address - Fax:214-823-2326
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23761122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist