Individual
LUCY BROOKS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3410 WORTH ST STE 160, DALLAS, TX 75246-2092
(214) 826-9797
(972) 996-0465
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
77806
GA
208600000X
Surgery Physician
N4832
TX
2086S0127X
Trauma Surgery Physician
N4832
TX
2086X0206X
Surgical Oncology Physician
Primary
N4832
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003193207A
—
GA
Enumeration date
06/13/2007
Last updated
08/28/2025
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