William E Wallace, DO

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

F7282 Issued in TX

Practice address

2000 Ben Merritt Dr
Suite B
Decatur, TX 76234-3848

Phone

(817) 380-6621

Fax

(817) 380-6622

NPI assigned

May 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

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 and National Provider Directory roles.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment
• William E Wallace DO

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colleyville, TX
  • NPI 1003360116
  NPD (past) Authorized official
• Wise Clinical Care Associates

  • Urgent Care Clinic/Center
  • Haslet, TX
  • NPI 1386112506
  NPD (past)
• Heartplace, PLLC

  • Cardiovascular Disease Physician
  • Franklin, TN
  • NPI 1417117912
  NPD (past)
• Phoebe Putney Memorial Hospital Inc

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  NPD (past)

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225087562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156",
            "telephone_number": "817-380-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BEN MERRITT DR",
            "address_2": "SUITE B",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343848",
            "telephone_number": "817-380-6621",
            "fax_number": "817-380-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "F7282",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "F7282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115246411",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8GH312",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vitality Medical PLLC
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LP
• Jennifer M Walker, FNP-BC
• Payton B Wall, PT,DPT
• Brianna Watkins
• Agatha Rae Watson, PA
• Whitney Nicole Watson, PA-C
• Amanda Marie Webb, MSN, FNP-C
• Morgan Alexander Weisser, CRNA

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Decatur, TX
• Providers in Decatur, TX by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.