RICHARD JAMES WALLACE JR. (NPI# 1083698609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083698609 |
| Entity Type | Individual |
| Full Name | RICHARD JAMES WALLACE JR. |
| Credential | MD |
| Practice Address |
11937 Us Highway 271 Tyler TX 75708-3154 |
| Mailing Address |
Po Box 731912 Dallas TX 75373-1912 |
| Practice Telephone | 9038777777 |
| Mailing Telephone | 9038777777 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2016-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
D9705 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 100861704 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811434400 | Richard Wallace | Registered Nurse | 4905 Hackamore Dr N, Colorado Springs, CO 80918-2632 | 2017-01-20 |
| 1023242112 | Richard Lance Wallace | Physical Therapist | 1034 Buchanan Bridge Rd, Chesterfield, SC 29709-6154 | 2009-05-05 |
| 1063656262 | Richard Scott Wallace | Social Worker | 10625 Redmond Rd, Austin, TX 78739-1654 | 2009-05-01 |
| 1710105911 | Richard Franklin Wallace | Marriage & Family Therapist | 3341 M St, Merced, CA 95348-2714 | 2007-04-23 |
| 1326199043 | Richard J. Wallace | Counselor | 1930 Stuart St, Berkeley, CA 94703-2215 | 2007-01-16 |
| 1750458402 | Richard Dean Wallace | Nutritionist | 914 13th Ave South, Great Falls, MT 59405 | 2006-11-29 |
| 1427155001 | Richard Lange Wallace | Psychiatry & Neurology | 8858 Scenic Bay Dr, Las Vegas, NV 89117-1026 | 2006-09-17 |
| 1275586448 | Richard Peterkin Wallace | Family Medicine | 1001 S Fort Harrison Ave, Suite 101, Clearwater, FL 33756-3941 | 2006-05-18 |
| 1881656940 | Richard M. Wallace | Specialist | 925 Highland Blvd., Suite 1180, Bozeman, MT 59715 | 2006-04-04 |
| 1972596443 | Richard J Wallace | Dentist | 20921 E Smoky Hill Rd, Suite A, Centennial, CO 80015 | 2005-08-30 |
| Street Address |
11937 US HIGHWAY 271 |
| City | TYLER |
| State | TX |
| Zip Code | 75708-3154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245233550 | Frances L. Elizondo | Physician Assistant | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-05-31 |
| 1497355481 | Jessie Ann Gibson | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-28 |
| 1538767397 | Ian Joseph Gomez | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-14 |
| 1588262562 | Jamie R Antwine | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-13 |
| 1679171797 | Christian Paul Fant | Dietitian, Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-10-12 |
| 1912512468 | Halle Ross-young | Psychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-09-11 |
| 1093328700 | Joshua Morgan | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-08-24 |
| 1811509011 | Kavya Parasa | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-08-19 |
| 1326657792 | Pelin D Strebler | Clinical Neuropsychologist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-07-30 |
| 1508483082 | Chi Nguyen Benson | Student in an Organized Health Care Education/Training Program | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2020-06-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427615699 | Aiat Radwan | Student in an Organized Health Care Education/Training Program | 11937 U Highway 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-23 |
| 1174170781 | Sanmitha Sundaram Kota | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-08-20 |
| 1952960437 | Parashar Trivedi | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-06-10 |
| 1659937506 | Sandhya Devaraj | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-16 |
| 1972169381 | Mary Kaar | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1396301701 | Joshua Penrod | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1558927962 | Ijeoma Nwaigwe | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1487210894 | David Pollard | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1477119873 | Aparna Kanuparthy | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
| 1275199689 | Prithvi Muddana | Student in an Organized Health Care Education/Training Program | 11937 Us Hwy 271, Attn: Kate Wells, Tyler, TX 75708 | 2019-05-13 |
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| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124515879 | East Texas Infusion Center, Pllc | Internal Medicine | 935 S Baxter Ave, Tyler, TX 75701-2245 | 2018-04-18 |
| 1144467515 | Mariejane Braza | Internal Medicine | 935 S Baxter Ave, #103, Tyler, TX 75701-2245 | 2009-01-07 |
| 1386633451 | David Leroy Lakey | Internal Medicine | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-10-20 |
| 1669460960 | Peter Francis Barnes | Internal Medicine | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-10-11 |
| 1376543546 | Steven L. Hickerson | Internal Medicine | 935 S Baxter Ave, Ste 103, Tyler, TX 75701-2245 | 2005-07-28 |
| 1912907353 | East Texas Infectious Disease Consultants, Pllc | Internal Medicine | 935 S Baxter Ave, Ste 103, Tyler, TX 75701-2245 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117838 | Infectious Disease Associates of Greater Houston LLC | Internal Medicine | 22999 Highway 59 N Ste 419, Kingwood, TX 77339-4502 | 2020-06-04 |
| 1528681566 | Ronak J Patel Md Pllc | Internal Medicine | 13567 Leeson Ln, Frisco, TX 75035-0806 | 2020-05-26 |
| 1023656865 | Faiza Tahir Md Pa | Internal Medicine | 500 N Kobayashi Ste B, Webster, TX 77598-4722 | 2019-12-11 |
| 1326681396 | First Choice Group LLC | Internal Medicine | 5866 S Staples St Ste 345, Corpus Christi, TX 78413-3700 | 2019-10-23 |
| 1063979482 | Prolixant Therapeutics LLC | Internal Medicine | 711 W 38th St Ste C8, Austin, TX 78705-1137 | 2019-02-21 |
| 1710459813 | Soofi Institute of Infectious Diseases & Wound Management Pllc | Internal Medicine | 3106 Acorn Wood Way, Houston, TX 77059-5826 | 2018-12-30 |
| 1073084299 | Ricardo Quezada Real Md Pllc | Internal Medicine | 951 York Dr Ste 103, Desoto, TX 75115-2052 | 2018-12-16 |
| 1598235194 | Idexpertcare Pa | Internal Medicine | 11797 South Fwy Ste 238, Burleson, TX 76028-7035 | 2018-11-27 |
| 1497237028 | Fred P Paleologo | Internal Medicine | 32631 Ryder Cup, Magnolia, TX 77354-6862 | 2018-08-30 |
| 1861972556 | Red Diamond Medical Group Pllc | Internal Medicine | 2700 Tibbets Dr # 301, Bedford, TX 76022 | 2018-08-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.