Richard L Wallner MD PA

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

F7283 Issued in TX

Legal business name

RICHARD L WALLNER MD PA

Practice address

2715 Bolton Boone Dr
Suite a
Desoto, TX 75115-2078

Phone

(972) 296-0086

Fax

(972) 298-5536

NPI assigned

Jul 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Richard Wallner

Title

President

Phone

(972) 296-0086

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1508179284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 BOLTON BOONE DR",
            "address_2": "SUITE A",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152078",
            "telephone_number": "972-296-0086",
            "fax_number": "972-298-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 BOLTON BOONE DR",
            "address_2": "SUITE A",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152078",
            "telephone_number": "972-296-0086",
            "fax_number": "972-298-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD L WALLNER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "WALLNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-296-0086",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "F7283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033326201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.