David R Wallace Jr., M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD.204718 Issued in LA

Practice address

1800 Ryan St Ste 105
Lake Charles, LA 70601-6078

Phone

(337) 439-4706

Fax

(337) 439-8110

NPI assigned

Jul 1, 2010

Last updated

Mar 12, 2025By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, LA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Louisiana State University School of Medicine in Shreveport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highland Clinic, a Prof Med CorpGroup PAC ID 3870493463, 60 clinicians

Gulf Coast Radiology LLCGroup PAC ID 6507242195, 4 clinicians

Center for Orthopaedics and Spine LLCGroup PAC ID 1557797206, 32 clinicians

Paradigm Health SystemGroup PAC ID 7012162464, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sterling Surgical Hospital Hospital, Slidell, LA, CCN 190256
• Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278
• Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
• Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040
• Ochsner Medical Center-Hancock Hospital, Bay Saint Louis, MS, CCN 250162

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 54)

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.

• Gulf Coast Radiology LLC

  • Diagnostic Radiology Physician
  • Lake Charles, LA
  • NPI 1326761925
  Medicare reassignment Care Compare group NPD Authorized official
• Center for Orthopaedics and Spine LLC

  • Orthopaedic Surgery Physician
  • Lake Charles, LA
  • NPI 1538703335
  Medicare reassignment Care Compare group NPD
• Highland Clinic, a Prof Med Corp

  • Multi-Specialty Clinic/Center
  • Shreveport, LA
  • NPI 1053315846
  Medicare reassignment Care Compare group NPD
• Paradigm Health System

  • Orthopaedic Surgery of the Spine Physician
  • Lacombe, LA
  • NPI 1780929604
  Medicare reassignment Care Compare group NPD
• Doctors' Hospital of Slidell, LLC

  dba Sterling Surgical Hospital

  • Diagnostic Radiology Physician
  • Slidell, LA
  • NPI 1518739440
  Medicare reassignment NPD
• Louisiana Orthopaedic Specialists, LLC

  dba Louisiana Orthopaedic Specialists

  • Clinic/Center
  • Lafayette, LA
  • NPI 1063669612
  Medicare reassignment NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD
• Radiology Associates of Southwest Louisiana

  • Diagnostic Radiology Physician
  • Alexandria, LA
  • NPI 1033215710
  Medicare reassignment NPD
• Second Avenue MRI LLC

  dba Advanced MRI

  • Diagnostic Radiology Physician
  • Lake Charles, LA
  • NPI 1629174339
  Medicare reassignment NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  Medicare reassignment NPD
• Center for Orthopaedics and Spine LLC

  • Orthopaedic Surgery Physician
  • Lake Charles, LA
  • NPI 1134877392
  NPD
• Doctors' Hospital of Slidell, LLC

  dba Cypress Pointe Hospital East

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1043392491
  NPD

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

• Doctors' Hospital of Slidell, LLC

  dba Cypress Pointe Hospital East

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1043392491
  Care Compare affiliation
• Ochsner Clinic Foundation

  dba Ochsner Medical Center Acute

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1811973100
  Care Compare affiliation
• Slidell Memorial Hospital

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1578568481
  Care Compare affiliation
• Specialists Hospital Shreveport, LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912118134
  Care Compare affiliation
• Ochsner Medical Center - Hancock LLC

  dba Ochsner Medical Center - Hancock

  • General Acute Care Hospital
  • Bay Saint Louis, MS
  • NPI 1588629968
  Care Compare affiliation

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1265743595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 RYAN ST STE 105",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706016078",
            "telephone_number": "337-439-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 RYAN ST STE 105",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706016078",
            "telephone_number": "337-439-4706",
            "fax_number": "337-439-8110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10310 The Grove Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708366455",
            "country_code": "US",
            "telephone_number": "225-761-5200",
            "fax_number": "225-761-5750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1455 E Bert Kouns Industrial Loop",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055634",
            "country_code": "US",
            "telephone_number": "318-798-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1453 E Bert Kouns Industrial Loop Ste 210",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711056810",
            "country_code": "US",
            "telephone_number": "318-798-4623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A136122",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD.204718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Walker, M.D.
• Richard Keith Walker, CRNA
• Robert Alan Walker, LCSW BCD
• Sarah Walker
• Patrick P Walkin, MD
• David Richard Wallace, MD
• Chase Walling, M.A., LPC
• Walson, Inc.
• Mary Walters
• Ward Chiropractic

• Diagnostic Radiology Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Diagnostic Radiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.