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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
G3885 | TX | Allopathic & Osteopathic Physicians |
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 |
Street Address |
17110 DALLAS PKWY SUITE 100 |
City | DALLAS |
State | TX |
Zip Code | 75248-1167 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 75248 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
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. |
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 |
Find all providers in DALLAS |
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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.