Individual
GREGORY N WALLINGFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
1500 RED RIVER ST, AUSTIN, TX 78701-1918
(512) 324-8933
Mailing address
1601 TRINITY ST, AUSTIN, TX 78712-1765
(512) 324-8933
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD460183
PA
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
S5290
TX
Other
Enumeration date
04/07/2014
Last updated
04/20/2021
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