Sylvin Wallace, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BACB906883 Issued in TX

Practice address

3901 Arlington Highlands Blvd
Suite 200 #4723
Arlington, TX 76018

Phone

(214) 687-2330

Fax

(817) 987-1628

NPI assigned

May 2, 2023

Last updated

May 2, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1285323683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 ARLINGTON HIGHLANDS BLVD",
            "address_2": "SUITE 200 #4723",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76018",
            "telephone_number": "214-687-2330",
            "fax_number": "817-987-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 ARLINGTON HIGHLANDS BLVD",
            "address_2": "SUITE 200 #4723",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76018",
            "telephone_number": "214-687-2330",
            "fax_number": "817-987-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SYLVIN",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "BACB906883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Marquez Wallace
• Danielle Wallace, BS
• Diane E Wallace, RD, CDE, RMT
• Kenneth Lee Wallace, DDS
• Rene Wallace
• Derhonda Waller
• Lynne Marie Waller
• Makeba Waller
• Randell Wayne Walling, D.C.
• Jo Beth Walls

• Behavior Technician in Arlington, TX
• Providers in Arlington, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.