Wallace Watts Jr., NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP132310 Issued in TX

Practice address

101 Potasio Street
Fabens, TX 79838

Phone

(915) 790-5700

NPI assigned

Nov 9, 2016

Last updated

Nov 21, 2023By the provider in NPPES

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El Paso County Hospital DistrictGroup PAC ID 2365431509, 208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24611/brand/1/csg/1/fhir/r4
• Direct secure messaging: wallace.watts@direct.myhealthep.org

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.

• El Paso County Hospital District

  dba University Medical Center of EL Paso

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1316936990
  Medicare reassignment Care Compare group NPD
• Umc El Paso Healthcare Inc

  • General Practice Physician
  • El Paso, TX
  • NPI 1528683810
  Medicare reassignment NPD
• El Paso County Hospital District

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1619747938
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• El Paso County Hospital District

  dba University Medical Center of EL Paso

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1316936990
  Care Compare affiliation
• El Paso County Hospital District

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1619747938
  Care Compare affiliation
• El Paso County Hospital District

  • Clinical Medical Laboratory
  • El Paso, TX
  • NPI 1932434925

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1245772128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202479",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753202479",
            "telephone_number": "915-790-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 POTASIO STREET",
            "city": "FABENS",
            "state": "TX",
            "postal_code": "79838",
            "telephone_number": "915-790-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "WALLACE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SLMT Inc (Medicine Shoppe)
• Rene Tapia, PHARM.D
• Texas Kids Dental Care of Fabens, PA
• Ulysses Urquidi, M.D.
• US Drug Mart Inc (Fabens Pharmacy)

• Family Nurse Practitioner in Fabens, TX
• Providers in Fabens, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.