MR. JOSEPH DERRICK WALLACE (NPI# 1235785437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235785437 |
| Entity Type | Individual |
| Full Name | MR. JOSEPH DERRICK WALLACE |
| Credential | RPH |
| Practice Address |
5960 Highway 105 Beaumont TX 77708-3700 |
| Practice Telephone | 4098922282 |
| Practice Fax Number | 4099248206 |
| Mailing Telephone | 4098922282 |
| Mailing Fax Number | 4099248206 |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2019-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 39338 | TX | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891275095 | Joseph Jelks Wallace | Nurse Practitioner | 23361 Ferndale Ave, Punta Gorda, FL 33980-4814 | 2018-08-16 |
| 1912419201 | Joseph Eric Wallace | Counselor | 237 26th St, Ogden, UT 84401 | 2017-10-26 |
| 1255699898 | Joseph C. Wallace | Case Manager/Care Coordinator | 58923 Business Center Dr, Suite C, D, & E, Yucca Valley, CA 92284-7311 | 2012-05-02 |
| 1629360268 | Joseph Wallace | Rehabilitation Practitioner | 100 Rosaschi Rd, Yerington, NV 89447-8722 | 2011-05-13 |
| 1790839728 | Joseph Patrick Wallace Jr. | Psychologist | 44 North Street, Danbury, CT 06810 | 2007-01-23 |
| 1255421012 | Joseph Francis Wallace IIi | Dentist | 23 Maple Ave, Greenwich, CT 06830-5620 | 2006-10-13 |
| 1104850957 | Joseph Claude Wallace | Surgery | 1031 Fairfax Park, Tuscaloosa, AL 35406-2807 | 2006-07-10 |
| Street Address |
5960 HIGHWAY 105 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77708-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689740342 | Retail Investors of Texas, Ltd. | Pharmacy | 5960 Highway 105, Beaumont, TX 77708-3700 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629445333 | Wael Hamdan | Dentist | 6970 Firethorn, Beaumont, TX 77708 | 2015-08-28 |
| 1649658238 | Sizewise Rentals LLC | Durable Medical Equipment & Medical Supplies | 11025 Eastex Freeway, Suites D/e, Beaumont, TX 77708 | 2015-05-14 |
| 1083804520 | Roland Melvin Williams | Dentist | 7640 Eastex Frwy, Beaumont, TX 77708 | 2007-07-31 |
| 1609980523 | Golden Triangle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 5125 Mcanelly Dr, Beaumont, TX 77708 | 2006-08-18 |
| 1598879413 | Golden Triangle Living Centers Inc | Intermediate Care Facility, Mentally Retarded | 5965 Navajo Trail, Beaumont, TX 77708 | 2006-08-18 |
| 1962441980 | Mobility Scooters | Durable Medical Equipment & Medical Supplies | 10955 A Eastex Freeway, Beaumont, TX 77708 | 2006-06-05 |
| 1932347606 | National Seating & Mobility, Inc | Home Health | 10945 Eastex Fwy, Beaumont, TX 77708-0902 | 2009-02-03 |
| 1003824814 | Apria Healthcare LLC | Durable Medical Equipment & Medical Supplies | 11125 Eastex Fwy, Beaumont, TX 77708-0906 | 2006-08-04 |
| 1548279888 | Pulse Homecare, Ltd. | Home Health | 10485 Eastex Fwy Ste C, Beaumont, TX 77708-1052 | 2006-08-05 |
| 1356966980 | Carol Devera Guillory | Occupational Therapist | 4535 Holst St, Beaumont, TX 77708-1531 | 2020-06-09 |
| Find all providers in zip 77708 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568096 | Laura M Alli | Pharmacist | 5350 Old Dowlen Rd Apt 923, Beaumont, TX 77706-6642 | 2020-11-02 |
| 1104468271 | Trey Crandall | Pharmacist | 4225 Gladys Ave Ste B, Beaumont, TX 77706-3644 | 2019-10-10 |
| 1619470499 | Mariana Mourad | Pharmacist | 6325 Tulip Dr, Beaumont, TX 77706-5533 | 2018-03-17 |
| 1811361462 | Azuka Ginigeme | Pharmacist | 3605 College Street, Walgreens Pharmacy, Beaumont, TX 77701 | 2015-11-19 |
| 1427422138 | Endalkachew Adane Alebachew | Pharmacist | 5995 W Windemere St, Beaumont, TX 77713-3431 | 2015-11-18 |
| 1295132561 | Daniel Negusse | Pharmacist | 3885 N Dowlen Road, Beaumont, TX 77706-6604 | 2014-12-02 |
| 1710300975 | Gregory M Magare | Pharmacist | 4550 N Major Dr, Beaumont, TX 77713-8587 | 2014-01-23 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| 1104269752 | Imadeddin Karaze | Pharmacist | 1680 E 6th St, Ste A, Beaumont, CA 92223-5756 | 2013-04-14 |
| 1679819114 | Fahed Omar Al Nabki | Pharmacist | 3885 N. Dowlen Rd., Beaumont, TX 77706 | 2013-01-02 |
| Find all providers in BEAUMONT | ||||
Please comment or provide details below to improve the information on MR. JOSEPH DERRICK WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.