| Mr James Kenneth Wallace, CRNA | |
|
703 E Marshall Ave, Suite 2000, Longview, TX 75601-5500 | |
| (903) 315-5300 | |
| (903) 315-5301 |
| Full Name | Mr James Kenneth Wallace |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 703 E Marshall Ave, Longview, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912014838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 228579 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr James Kenneth Wallace, CRNA 195 W 1st St, Rusk, TX 75785-1201 Ph: (903) 683-2676 | Mr James Kenneth Wallace, CRNA 703 E Marshall Ave, Suite 2000, Longview, TX 75601-5500 Ph: (903) 315-5300 |
William W. Burlingame, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1907 Warwick Circle East, Longview, TX 75601 Phone: 903-757-4453 | |
Richard Klima, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 700 E Marshall Ave, Longview, TX 75601 Phone: 903-315-2000 | |
Eric Fernandez, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6580 Judson Rd, Longview, TX 75605 Phone: 903-663-3600 | |
Randall Wayne Young, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 906 Judson Rd, Longview, TX 75601 Phone: 903-331-0506 Fax: 903-331-0462 | |
Mark D Bruce, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2901 N 4th St, Longview, TX 75605 Phone: 903-232-3606 Fax: 903-593-4290 | |
John Ryan Mccubbin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 140 Timber Falls Dr, Longview, TX 75605 Phone: 903-297-8640 | |
Kristy Dupus, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 6580 Judson Rd, Longview, TX 75605 Phone: 800-939-7440 |