SearchTexas106H00000X

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