Organization
PCDI HEALTHCARE AND CONSULTANTS/ THE WALLACE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY DE'WAYN'E WALLACE CRNA (CEO)
(972) 955-1911
Entity
Organization
Contact information
Practice address
638 CEDARCLIFF DR, DALLAS, TX 75217-4208
(972) 955-1911
(214) 467-4315
Mailing address
638 CEDARCLIFF DR, DALLAS, TX 75217-4208
(972) 955-1911
(214) 467-4315
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32016909494
HOME HEALTH
TX
Enumeration date
08/21/2008
Last updated
08/21/2008
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