Individual
ARNOLD WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 HIGHWAY 59 LOOP N, WHARTON, TX 77488-7807
(979) 532-2500
Mailing address
714 FM 1960 RD W, SUITE 206, HOUSTON, TX 77090-3405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E4745
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8W2690
BCBSTX
TX
Enumeration date
12/28/2005
Last updated
10/29/2007
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