Wallace Sports Medicine PA

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

WALLACE SPORTS MEDICINE PA

Practice address

2313 Ridge Rd Ste 105B
Rockwall, TX 75087-5141

Phone

(972) 722-4830

NPI assigned

Feb 20, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Wallace, MD

Title

President

Phone

(972) 722-4830

Specialties & licenses 1

Addresses

Other names 1

• Wallace Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1770823213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8440 WALNUT HILL LN",
            "address_2": "SUITE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752313833",
            "telephone_number": "214-506-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 RIDGE RD STE 105B",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875141",
            "telephone_number": "972-722-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE SPORTS MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-722-4830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wallace Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Nicole Walker, PT, MSPT
• Erin Elaine Walker, DDS
• Jessica Walker, LPC
• Summer Walker, LPC
• Wallace Orthopaedics and Sports Medicine
• Brenda Wallace, PA-C
• Brittany Wallace, D.P.T.
• Jeffrey S Wallace, M.D.
• Mary Elise Wallace, MSRD/LD
• Gabriella Walton

• Orthopaedic Surgery Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.