Active NPI
Zachary Wallace, PHARMD
- Pharmacist
- Dallas, TX
National Provider Identifier
1275139826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 67400
- Practice address
- 1235 S Buckner Blvd
Dallas, TX 75217-4306 - Phone
- (214) 391-2151
- NPI assigned
- Dec 9, 2020
- Last updated
- Dec 9, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 67400 | TX | Primary |
Addresses
Primary practice location
1235 S Buckner Blvd
Dallas, TX 75217-4306
Mailing address
1800 N Hall St Apt 441
Dallas, TX 75204-4152
Phone (314) 707-6718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67400 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1275139826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 N HALL ST APT 441",
"city": "DALLAS",
"state": "TX",
"postal_code": "752044152",
"telephone_number": "314-707-6718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 S BUCKNER BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752174306",
"telephone_number": "214-391-2151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "ZACHARY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-09",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "67400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.