Allen Wallace

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

22954496 Issued in TX

Practice address

3506 E 14TH St
Lubbock, TX 79403-6207

Phone

(806) 777-3607

NPI assigned

Jul 25, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1417683293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6923 INDIANA AVE # 335",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794136111",
            "telephone_number": "806-491-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 E 14TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794036207",
            "telephone_number": "806-777-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALLEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-25",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "TX",
            "license": "22954496",
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "TX",
            "license": "22954496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417683293",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awall@awallsdrivingservice.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "(806) 491-9778",
            "address_1": "6923 Indiana Ave # 335",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794136111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.awallsdrivingservice.com",
            "affiliation": "N",
            "endpointDescription": "direct website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "awall@awallsdrivingservice.com",
            "address_1": "6923 Indiana Ave # 335",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794136111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Paige Walker, BSN, RN
• Michael Walker, D.D.S.
• Teryn J'Nae Walker, PHARM.D.
• Trevor Walker, M.D.
• Jalyn Wall, CFNP
• Kristi Wallace, RBT
• Mikaela Wallace, MD
• Sydney Laine Waller
• Connor Walp
• Courtney E Walraven, LCSW

• Private Vehicle in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Private Vehicle in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.