Provider Demographics
NPI:1447691381
Name:WRIGHT, KIM R (RD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SCOTT & WHITE HEALTHCARE
Mailing Address - Street 2:2401 S. 31ST ST.
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508-0001
Mailing Address - Country:US
Mailing Address - Phone:254-501-6479
Mailing Address - Fax:
Practice Address - Street 1:SCOTT & WHITE HEALTHCARE
Practice Address - Street 2:2401 S. 31ST ST.
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-501-6479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82497133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal