Individual
DR. PERRY WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
(512) 628-3367
Mailing address
124 RAINBOW VALLEY TRL, SAN MARCOS, TX 78666-3975
(830) 339-0718
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M3420
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M3420
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181008701
—
TX
01
—
8S6187
BLUE CROSS
TX
01
—
P00326295
RAILROAD MEDICARE
TX
Enumeration date
05/25/2006
Last updated
08/03/2026
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