Drew Wayne Fallis Sr., D.D.S

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4870 Issued in OK

Practice address

2200 Bergquist Dr Ste 1
Attn: Darlon Jackson, Credentials Manager
Lackland a F B, TX 78236-9908

Phone

(210) 292-7395

Fax

(210) 292-7964

NPI assigned

Jul 24, 2006

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679595946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 MANTANO RDG",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234705",
            "telephone_number": "210-372-0777",
            "fax_number": "210-292-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "address_2": "ATTN: DARLON JACKSON, CREDENTIALS MANAGER",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-7395",
            "fax_number": "210-292-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLIS",
        "first_name": "DREW",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OK",
            "license": "4870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charisma Bautista Evangelista, M.D.
• Grant Hopkins Evans, DO, FACS
• Matthew Thomas Evans
• Beth A. Ewing, CNM, WNNP
• Jeffrey S Fait
• Anna Zelfond Feldman, M.D.
• Louise Kim Feuge, FNP
• Arnaldo Javier Figueroa, PHARMD
• Roger W Finley, RESP THERAPIST
• Anthony Richard Fletcher

• Orthodontics and Dentofacial Orthopedics Dentistry in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.