CHARLES ALAN WALLACE


Address: 17110 Dallas Pkwy, Suite 100, Dallas, TX 75248-1167
Phone: 9723807090

CHARLES ALAN WALLACE (NPI# 1164422481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164422481
Entity Type Individual
Full Name CHARLES ALAN WALLACE
Credential MD
Practice Address 17110 Dallas Pkwy
Suite 100
Dallas
TX 75248-1167
Practice Telephone 9723807090
Practice Fax Number 9723807016
Mailing Telephone 9723807090
Mailing Fax Number 9723807016
Enumeration Date 2005-07-28
Last Update Date 2010-07-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
G3885 TX Allopathic & Osteopathic Physicians

Other Providers CHARLES WALLACE

NPI Name Taxonomy Address Enumeration
1902140932 Charles L Wallace Counselor 2901 E. 20th Suite 104, Farmington, NM 87499 2012-11-15
1073643862 Charles Wayne Wallace Dentist 502 N Coalter St, Staunton, VA 24401-3401 2007-03-07
1063584746 Charles E Wallace Dentist 3221 Eastlake Ave E Ste 130, Seattle, WA 98102-7125 2006-11-15
1144229600 Charles Douglas Wallace Orthopaedic Surgery 3030 Childrens Way, Ste 410, San Diego, CA 92123-4232 2005-07-18
1780125203 Charles Jerome Wallace Counselor 55 W 125th St Fl 11, New York, NY 10027-4516 2017-03-16
1851506463 Charles William Wallace Marriage & Family Therapist 5738 Olde Wadsworth Blvd, Arvada, CO 80002-2535 2007-05-14
1578621231 Charles R. Wallace Jr. Urology 1325 Eastmoreland Ave, Suite 425, Memphis, TN 38104-3519 2006-12-05
1881702736 Charles T Wallace Anesthesiology 171 Ashley Ave, Charleston, SC 29425-0001 2006-08-29
1780652792 Charles W Wallace Family Medicine 4455 Dressler Rd Nw, Canton, OH 44718-2785 2006-03-08

Office Location

Street Address 17110 DALLAS PKWY
SUITE 100
City DALLAS
State TX
Zip Code 75248-1167

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326312356 Frankford Interventional Pain Center, LLC Clinic/Center 17110 Dallas Pkwy, Ste 125, Dallas, TX 75248-1167 2012-03-08
1770883589 Accent Interventional Procedure Center, LLC Clinic/Center 17110 Dallas Pkwy, Ste 125, Dallas, TX 75248-1167 2010-10-26
1467772335 Consolidated Pain Procedure Center LLC Clinic/Center 17110 Dallas Pkwy, Ste 125, Dallas, TX 75248-1167 2010-06-02
1902135767 Ambulatory Spine Procedure Center, LLC Clinic/Center 17110 Dallas Pkwy, Suite 125, Dallas, TX 75248-1167 2009-12-08
1073766432 Bentree Pain Procedure Center Clinic/Center 17110 Dallas Pkwy, Suite 125, Dallas, TX 75248-1167 2008-10-29
1497977995 Tonja Annettee Vazquez Nurse Anesthetist, Certified Registered 17110 Dallas Pkwy, Suite # 125, Dallas, TX 75248-1167 2007-05-03
1447475306 Darren Crosbie, D.d.s. Dentist 17110 Dallas Pkwy, #140, Dallas, TX 75248-1167 2007-04-16
1124180120 Bent Tree Family Physician, Pa Family Medicine 17110 Dallas Pkwy, Suite 100, Dallas, TX 75248-1167 2006-12-15
1740223429 Bent Tree Surgery Center Clinic/Center 17110 Dallas Pkwy, 100, Dallas, TX 75248-1167 2006-06-13
1407849052 Guy Lee Culpepper Family Medicine 17110 Dallas Pkwy, #100, Dallas, TX 75248-1167 2005-08-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093336398 Rachel Carrithers Registered Nurse 7611 El Pendsador, Dallas, TX 75248 2020-04-28
1538621024 Syreeta Williams Specialist 16690 Dallas Parkway, Suite 208, Dallas, TX 75248 2019-04-03
1225505928 Bent Tree Counseling, Pllc Marriage & Family Therapist 16800 North Dallas Parkway, Suite 100, Dallas, TX 75248 2018-10-31
1649764598 Annie Girson Dentist 16000 Preston Rd. Suite 310, Dallas, TX 75248 2018-06-14
1821503772 Affordable Dentist Near Me Dallas Pllc. Dentist 14902 Preston Road. Suite 201, Dallas, TX 75248 2017-12-13
1477077717 Children's Dental At Preston Trail, PC Dentist 17194 Preson Road, Dallas, TX 75248 2017-07-28
1871023481 Caroline Ford Psychologist 16150 Preston Road, Dallas, TX 75248 2017-06-15
1679940902 North Texas Cin, Inc. Clinic/Center 15770 North Dallas Parkway, Suite 900, Dallas, TX 75248 2015-08-21
1508246240 Arzu Shams Counselor 17103 Preston Rd Ste 230, Dallas, TX 75248 2015-06-08
1992182174 Texas Dentistry for Kids Richardson, Pllc Dentist 7989 Beltline Rd Ste# 107, Dallas, TX 75248 2015-04-27
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Taxonomy Information

Taxonomy Code 2086S0122X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Plastic and Reconstructive Surgery

Taxonomy Definition

A surgeon who specializes in plastic and reconstructive surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699179390 Sam T. Hamra M.d. P. A. Surgery 4131 N Central Expy # 950, Dallas, TX 75204-2102 2014-10-09
1669819736 Travis Guthrie Boyd Surgery 1801 Inwood Rd Fl 4, Dallas, TX 75235-7202 2013-05-30
1104950443 A and M Surgery Center Rllp Surgery 7777 Forest Ln Ste C637, Dallas, TX 75230-6869 2007-03-16
1699851923 Ben J Tittle Surgery 10743 Preston Rd, Dallas, TX 75230 2006-10-30
1538113592 Jeffrey A Fearon Surgery 7777 Forest Ln Ste C700, Dallas, TX 75230-2518 2006-05-22
1225002538 Plastic and Craniofacial Surgery for Infants and Children, P.a. Surgery 6300 Harry Hines Blvd, #600, Dallas, TX 75235-5259 2006-02-14
1881670172 Jeffrey Donald Hopkins Surgery 3450 W Wheatland Road, Suite 425, Dallas, TX 75237 2005-12-19
1093171761 Reconstructive Microsurgery and Lymphedema Associates Surgery 7777 Forest Ln Ste B216, Dallas, TX 75230-6810 2016-01-11
1083023303 Stephanie K. Teotia Md Pa Surgery 4231 Cedar Springs Rd, Dallas, TX 75219-2691 2014-08-12
1356699805 Farah Khan Inc Surgery 2801 Lemmon Ave, 300, Dallas, TX 75204-2356 2012-08-15
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Competitor

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City DALLAS
Zip Code 75248

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Dataset Information

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.

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