Individual
DR. MARK KOWALSKI WALLACE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3851 ROGER BROOKE DR, FT SAM HOUSTON, SAN ANTONIO, TX 78234
(210) 916-0775
Mailing address
12443 TECH RIDGE BLVD, #712, AUSTIN, TX 78753
(210) 818-7958
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01053948A
IN
Other
Enumeration date
10/25/2005
Last updated
07/08/2007
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