Active NPI
Scott Wallis, D.C.
- Neurology Chiropractor
- Hurst, TX
National Provider Identifier
1053426460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- 6346
- Practice address
- 416 W Bedford Euless Rd
Hurst, TX 76053-3958 - Phone
- (817) 285-8950
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 6346 | TX | Primary |
Addresses
Primary practice location
416 W Bedford Euless Rd
Hurst, TX 76053-3958
Mailing address
416 W Bedford Euless Rd
Hurst, TX 76053-3958
Phone (817) 285-8950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6346 | TX | MD | Neurology Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053426460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 W BEDFORD EULESS RD",
"city": "HURST",
"state": "TX",
"postal_code": "760533958",
"telephone_number": "817-285-8950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 W BEDFORD EULESS RD",
"city": "HURST",
"state": "TX",
"postal_code": "760533958",
"telephone_number": "817-285-8950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIS",
"first_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "TX",
"license": "6346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurst, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.