August Wallace, O.D

NPI 1477750081 · on the registry since 2007

Practice

Address: 3032 N Eastman Rd Ste 100
Longview, TX 75605
Phone: (903) 663-2020
Fax: (903) 663-2353
Organisation at this address: Amwallace, Llc
Med Southwest, Pllc
Mobberly Baptist Church
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 152W00000X
152W00000X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2021-09-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas