Provider Demographics
NPI:1689677759
Name:WRIGHT, LAURIE G (MD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:G
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:G
Other - Last Name:WRIGHT-SANDOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9229 LBJ FWY
Mailing Address - Street 2:STE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3405
Mailing Address - Country:US
Mailing Address - Phone:800-346-0747
Mailing Address - Fax:972-739-2638
Practice Address - Street 1:3100 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0436
Practice Address - Country:US
Practice Address - Phone:972-915-3600
Practice Address - Fax:972-915-3636
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10800207P00000X, 207PE0004X
TXJ4623207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100503121Medicaid
NV100503121Medicaid
NV39006Medicare PIN
NVV39006Medicare PIN