Brandon Wallace, DPT, PTA

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

1380704 Issued in TX

Practice address

250 US-377
Suite 300
Argyle, TX 76226

Phone

(940) 489-1460

NPI assigned

Oct 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bir JV LLP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901
  NPD (past)

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1750753810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 BLOCK DR APT 1112",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750388010",
            "telephone_number": "903-436-1880",
            "fax_number": "504-349-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 US-377",
            "address_2": "SUITE 300",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "76226",
            "telephone_number": "940-489-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 N Main St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760863267",
            "country_code": "US",
            "telephone_number": "817-662-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BRANDON",
        "credential": "DPT, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-28",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "LA",
            "license": "A9272",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2146592",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1380704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindra Tucker, HLP
• Misti Underwood, COTA
• Upward Worx, Inc
• Kara Ann Wade, MSN, CNM
• Mary Francis Walker
• Abbey J Warren, PTA
• Chris Washam, LCSW
• Laura Jean Watson
• Janna Wyatt Weaver, RDN, LD
• Ashley L Whitlatch, APN

• Orthopedic Physical Therapist in Argyle, TX
• Providers in Argyle, TX by specialty
• Orthopedic Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.