Richard James Wallace JR.
Infectious Disease
11937 Us Highway 271
Tyler
, Texas 75708-3154
Richard James Wallace JR.
Infectious Disease
11937 Us Highway 271
Tyler
, Texas 75708-3154
(903) 877-7777
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About
Features
Specialties
- Infectious Disease
Languages spoken
- English
Location
First Address
- Richard James Wallace JR.
- Po Box 731912
- Dallas, TX
- Zip : 75373-1912
- Phone : (903) 877-7777
Second Address
- Richard James Wallace JR.
- 11937 Us Highway 271
- Tyler, TX
- Zip : 75708-3154
- Phone : (903) 877-7777
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0200X | Infectious Disease | D9705 | TX |
National Provider Identifier
| NPI | 1083698609 |
|---|---|
| Provider Name | Richard James Wallace JR. |
| First Address | Dallas, TX 75373-1912 |
| Second Address | Tyler, TX 75708-3154 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/12/2005 |
| Last Update Date | 21/10/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100861704 | (05) | TX |
| C23113 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.