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Henry Wallace
NPI 1871155242 · on the registry since 2019 · sole proprietor
Practice
- Address
- 6236 Rhones Quarter Rd Lot 13
Tyler, TX 75707 - Phone
- (903) 952-9869
Registry record
- Primary taxonomy
- 106H00000X
106H00000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-07-05
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