Michael N. Wall, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G1227 Issued in TX

Practice address

4085 De Zavala Rd
Suite 200
Shavano Park, TX 78249-2084

Phone

(210) 558-6288

Fax

(210) 558-6289

NPI assigned

Jun 5, 2006

Last updated

Mar 25, 2015By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Michael N Wall, MD

  • Nephrology Physician
  • Shavano Park, TX
  • NPI 1063678894
  Authorized official Same address or phone
• Inpatient Consultants of Texas, PLLC

  • Hospitalist Physician
  • Port Arthur, TX
  • NPI 1184918807
  NPD (past)
• Inpatient Consultants of Texas, PLLC.

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1508890500
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1639118730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1606",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782961606",
            "telephone_number": "210-558-3628",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD",
            "address_2": "SUITE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MICHAEL",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "G1227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035387201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Gail Vaughan, DDS
• Veterans Healthcare System
• Katrina Salinas Villa, FNP
• Heather Walchar, LCSW
• Walgreen Co (Walgreens #03571)
• Janessa Lavane Webster, APRN
• Michelle Dawn Welch, MD
• Sandra Kay Wiley, BSN, CCP, LP
• Sharon Wolf, COTA
• Steven Wulfe

• Nephrology Physician in Shavano Park, TX
• Providers in Shavano Park, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.