William E Wallace, DO is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Decatur, Texas. His current practice location is
2000 Ben Merritt Dr, Suite B, Decatur, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 380-6621.
William E Wallace is licensed to practice in Texas (license number F7282) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225087562.
Physician's Profile
| Full Name | William E Wallace |
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| Gender | Male |
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| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
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| Location | 2000 Ben Merritt Dr, Decatur, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1225087562
- Provider Enumeration Date: 05/06/2006
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 9638198195
- Enrollment ID: I20191217000186
Medical Identifiers
Medical identifiers for William E Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225087562 | NPI | - | NPPES |
| 115246411 | Medicaid | TX | |
| 8GH312 | Other | TX | BCBSTX |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | F7282 (Texas) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | F7282 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. William E Wallace allows following entities to bill medicare on his behalf.
| Entity Name | Trinity Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083653752
PECOS PAC ID: 7911816020
Enrollment ID: O20031106000316 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. William E Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
William E Wallace, DO
Po Box 2078,
Decatur, TX 76234-6156
Ph: (817) 380-6621 | William E Wallace, DO
2000 Ben Merritt Dr, Suite B,
Decatur, TX 76234-3848
Ph: (817) 380-6621 |
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