WALLACE HENRY JR. (NPI# 1316311715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316311715 |
| Entity Type | Individual |
| Full Name | WALLACE HENRY JR. |
| Practice Address |
1055 S Stapley Dr Mesa AZ 85204 |
| Mailing Address |
1055 S Stapley Dr Mesa AZ 85204-5013 |
| Practice Telephone | 4808339100 |
| Mailing Telephone | 4808332641 |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
AZ | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1055 S STAPLEY DR |
| City | MESA |
| State | AZ |
| Zip Code | 85204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386649952 | Jeffrey M Gorzitze | Nurse Anesthetist, Certified Registered | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2005-06-20 |
| 1013481977 | Arizona Oculofacial Plastic Orbit and Cosmetic Surgery, LLC | Clinic/Center | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2019-01-14 |
| 1043710759 | Jordan Bluth | Optometrist | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2018-02-19 |
| 1881919967 | Southwestern Eye Center Ltd | Prosthetic/Orthotic Supplier | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2010-04-01 |
| 1093970931 | Matthew Palmer | Optometrist | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2008-07-21 |
| 1073703757 | Phillip David Boyer | Ophthalmology | 1055 S Stapley Dr, Mesa, AZ 85204 | 2007-07-27 |
| 1194885590 | Denise Dealva Garcia | Ophthalmology | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2006-12-08 |
| 1801983473 | Nicolas Uzcategui | Ophthalmology | 1055 S Stapley Dr, Mesa, AZ 85204 | 2006-10-06 |
| 1902834922 | Southwestern Eye Center Ltd | Clinic/Center | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2006-06-29 |
| 1780657288 | Kristia L Owens | Optometrist | 1055 S Stapley Dr, Mesa, AZ 85204-5013 | 2006-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 246ZS0410X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Technologist |
| Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. |
| Notes: Source: Association of Surgical Technologists, "Job Description: Surgical Technologist," 2014. [7/1/2014: code modified, title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659373322 | Grand Canyon Perfusion, Inc. | Specialist/Technologist, Other | 2753 E Broadway Rd, #101-454, Mesa, AZ 85204-1579 | 2005-08-12 |
| 1083035638 | Kelly Stanton | Specialist/Technologist, Other | 1400 S Dobson Rd, Mesa, AZ 85202-4707 | 2013-12-29 |
| 1821248311 | Ross Mcdonald, Surgical Assistant-certified | Specialist/Technologist, Other | 1524 E Fairbrook St, Mesa, AZ 85203-5028 | 2008-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588106918 | Jen Ramirez | Specialist/Technologist, Other | 8900 E Raintree Dr Ste 400, Scottsdale, AZ 85260-7307 | 2016-11-16 |
| 1083078471 | Hannah M Cerynik | Specialist/Technologist, Other | 1821 E Tierra Buena Ln, Phoenix, AZ 85022-3351 | 2016-04-12 |
| 1053756874 | Merlita May Parker-leach | Specialist/Technologist, Other | 9034 S Silkwood Ln, Tucson, AZ 85756-6119 | 2013-05-07 |
| 1417228909 | Jason Fort | Specialist/Technologist, Other | 2778 E Superior Rd, San Tan Valley, AZ 85143-4573 | 2012-01-16 |
| 1851610554 | Robert J Russ | Specialist/Technologist, Other | 420 W Billy Creek Dr, Lakeside, AZ 85929-6830 | 2010-05-20 |
| 1043441066 | Mackenzie Renae Johnson | Specialist/Technologist, Other | 1809 Thistle Rd, Flagstaff, AZ 86004-7790 | 2009-08-07 |
| 1003057050 | Robert Hunter Mcmaster | Specialist/Technologist, Other | 5279 W Lone Cactus Dr, Glendale, AZ 85308-9146 | 2009-03-19 |
| 1366681959 | Right Hands Assisting LLC | Specialist/Technologist, Other | 27646 N 62nd Pl, Scottsdale, AZ 85266-8757 | 2009-02-05 |
| 1073724670 | Lori Marie Bowyer | Specialist/Technologist, Other | 11426 N 43rd Dr, Glendale, AZ 85304-3516 | 2007-05-24 |
| 1992911663 | Robyn Kalota | Specialist/Technologist, Other | 5483 W Carriage Dr, Tucson, AZ 85742-8115 | 2007-05-16 |
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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.