Organization
RICHARD L WALLNER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD WALLNER (PRESIDENT)
(972) 296-0086
Entity
Organization
Contact information
Practice address
2715 BOLTON BOONE DR, SUITE A, DESOTO, TX 75115-2078
(972) 296-0086
(972) 298-5536
Mailing address
2715 BOLTON BOONE DR, SUITE A, DESOTO, TX 75115-2078
(972) 296-0086
(972) 298-5536
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
F7283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033326201
—
TX
Enumeration date
07/22/2010
Last updated
07/22/2010
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