Individual
DR. JEFFREY S WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6800 HERITAGE PKWY STE 102, ROCKWALL, TX 75087-8746
(972) 463-1253
(214) 607-1641
Mailing address
PO BOX 2108, ROCKWALL, TX 75087-5008
(972) 463-1253
(972) 463-0758
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J3932
TX
Other
Enumeration date
08/10/2006
Last updated
01/06/2020
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