Individual
JEAN OLDHAM WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Mailing address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
G5445
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122889202
—
TX
Enumeration date
06/15/2005
Last updated
03/25/2016
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