| Dr Tony Glen Wallen, DO | |
|
2800 State Highway 24 Ste A, Commerce, TX 75428-2017 | |
| (903) 886-3161 | |
| (903) 453-3923 |
| Full Name | Dr Tony Glen Wallen |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 5 Years |
| Location | 2800 State Highway 24 Ste A, Commerce, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932720349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7421 (Oklahoma) | Secondary |
| 207Q00000X | Family Medicine | V1914 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hunt Regional Medical Center | Greenville, TX | Hospital |
| Chickasaw Nation Medical Center | Ada, OK | Hospital |
| Arbuckle Memorial Hospital | Sulphur, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Chickasaw Nation Division Of Health | 8426957523 | 217 |
| Entity Name | Chickasaw Nation Division Of Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255364923 PECOS PAC ID: 8426957523 Enrollment ID: O20040108000364 |
| Entity Name | Hunt Memorial Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598750721 PECOS PAC ID: 6406768936 Enrollment ID: O20040424000352 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tony Glen Wallen, DO 1921 Stonecipher Dr, Ada, OK 74820-3439 Ph: (580) 436-3980 | Dr Tony Glen Wallen, DO 2800 State Highway 24 Ste A, Commerce, TX 75428-2017 Ph: (903) 886-3161 |
Thomas C Selvaggi, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1705 Live Oak St, Commerce, TX 75428 Phone: 903-886-8818 Fax: 903-886-8765 | |
Richard R Selvaggi, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1705 Live Oak St, Commerce, TX 75428 Phone: 903-886-8818 |