Individual
DR. ROBERT RANDOLPH WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
547 LUPIN ST, BELLAIRE, TX 77401-5023
(713) 665-0852
Mailing address
547 LUPIN ST, BELLAIRE, TX 77401-5023
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
D9706
TX
Other
Enumeration date
03/27/2007
Last updated
07/11/2007
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