Drew George Wallace, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6345 Issued in TX

Practice address

1801 West Avenue N
San Angelo, TX 76904

Phone

(325) 949-7878

Fax

(325) 944-7703

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Physical Medicine and Rehabilitation

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Drew G. Wallace, Inc.

  dba Angelo Chiropractic Center

  • Neurology Chiropractor
  • San Angelo, TX
  • NPI 1003126236
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205921608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WEST AVENUE N",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-949-7878",
            "fax_number": "325-944-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 WEST AVENUE N",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-949-7878",
            "fax_number": "325-944-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DREW",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill D'Shannon Walker, CCC SLP
• Lacy Dawn Walker, OTR
• Wall Isd
• Jeffery Wall, MS
• Timothy Jason Wall, D.D.S.
• Michael Wallace
• Jamie Jean Waller
• Kelsey Walling, RD, LD, CNSC
• Margaret E Walters, MSW
• Kelsey Danielle Walts

• Chiropractor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Chiropractor in Texas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.