Jeanne Wallace, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G4871 Issued in TX

Practice address

8200 Walnut Hill LN
Dallas, TX 75231-4426

Phone

(214) 345-6789

NPI assigned

Dec 21, 2005

Last updated

Feb 17, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Akshay Vakharia M.D.,PLLC

  • Anesthesiology Physician
  • Denton, TX
  • NPI 1043484819
  NPD (past)
• Denton Anesthesiology Associates, PA

  • Anesthesiology Physician
  • Denton, TX
  • NPI 1588622815
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1164408043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7557 RAMBLER RD",
            "address_2": "SUITE 706",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314142",
            "telephone_number": "214-369-0800",
            "fax_number": "214-378-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314426",
            "telephone_number": "214-345-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "G4871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131346204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131346201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craigreon Levar Wallace, PA
• Darcy Wallace
• Daryariel Wallace
• Elizabeth Wallace, PH.D., CCC
• Jahnnae Monique Wallace, LMT
• John David Wallace, DDS, MD
• Lajuana Wallace
• Lesleigh Lencola Wallace, PHARM.D.
• Lucy Brooks Wallace, M.D.
• Melissa Baker Wallace, M.D.

• Anesthesiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.