| Christopher Wallace, MD | |
|
300 University Blvd, Round Rock, TX 78665-1032 | |
| (512) 509-0100 | |
| (512) 218-6330 |
| Full Name | Christopher Wallace |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 300 University Blvd, Round Rock, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033599790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 4301107981 (Michigan) | Primary |
| Entity Name | Ascension Borgess Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568416311 PECOS PAC ID: 5294645750 Enrollment ID: O20040209000029 |
| Entity Name | Kalamazoo Emergency Associates, Plc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942251244 PECOS PAC ID: 5890685473 Enrollment ID: O20040317001078 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Wallace, MD Po Box 840003, Dallas, TX 75284-0003 Ph: () - | Christopher Wallace, MD 300 University Blvd, Round Rock, TX 78665-1032 Ph: (512) 509-0100 |
Clarke Worley Goodman, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Round Rock Ave, Round Rock, TX 78681 Phone: 512-341-1000 | |
Dr. Jaclyn Ngoc Minh Nguyen, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 300 University Blvd, Round Rock, TX 78665 Phone: 512-509-0100 | |
Kristen Faye Walker, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3341 Winding River Trl, Round Rock, TX 78681 Phone: 325-260-9002 | |
Dr. Peter John Richerson, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 300 University Blvd, Round Rock, TX 78665 Phone: 512-509-0100 | |
Dr. James Porter Mcdonough Iii, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 300 University Blvd, Round Rock, TX 78665 Phone: 512-509-0100 | |
Jordan Scaff, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2400 Round Rock Ave, Round Rock, TX 78681 Phone: 512-341-1000 |