Ted W Wallis, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

E6677 Issued in TX

Practice address

4007 James Casey St Ste B200
Austin, TX 78745-1181

Phone

(512) 441-9799

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Central Texas Lung Associates

  • Specialist
  • Austin, TX
  • NPI 1417129719
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1386648228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 WALLIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787464637",
            "telephone_number": "512-329-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 JAMES CASEY ST STE B200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451181",
            "telephone_number": "512-441-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "TED",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E6677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Elaine Waller, M.S., C.G.C.
• Loise King Waller, PHD
• Jessica Heard Walling, APRN
• Lindsay Walling
• Gregory N Wallingford, MD, MBA
• Andrew Louis Walls, M.D.
• Sara Genevieve Walls, LPC-ASSOCIATE
• Walnut Hills Nursing and Rehabilitation, LTD.
• Brianna Walrafen-Rinaldi, FNP
• Adriane Walsh, MSW

• Specialist in Austin, TX
• Providers in Austin, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.