DR. PATRICK WALLACE (NPI# 1285131474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285131474 |
| Entity Type | Individual |
| Full Name | DR. PATRICK WALLACE |
| Credential | DO |
| Practice Address |
901 Rancho Ln Ste 135 Las Vegas NV 89106-3826 |
| Practice Telephone | 7023837885 |
| Practice Fax Number | 7023838235 |
| Mailing Telephone | 7023837885 |
| Mailing Fax Number | 7023838235 |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2018-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376184408 | Patrick Wallace | Counselor | 4104 Delta St, San Diego, CA 92113-4113 | 2019-09-30 |
| 1477846020 | Patrick Albert Wallace II | Technician, Other | 4801 Reading St, Dallas, TX 75247-6716 | 2011-05-16 |
| 1427294875 | Patrick Wallace | Physical Therapist | 2027 Pulaski Hwy, Havre De Grace, MD 21078-2143 | 2009-01-06 |
| 1598825002 | Patrick J Wallace | Physician Assistant | 320 E North Ave Fl 6, Pittsburgh, PA 15212-4756 | 2006-12-12 |
| 1740219369 | Patrick Joseph Wallace | Surgery | 1315 St Joseph Pkwy, Suite 1800, Houston, TX 77002-8233 | 2006-07-03 |
| 1508857053 | Patrick L Wallace | Dentist | 1119 Walnut Dr, Suite 2, Ardmore, OK 73401-2360 | 2005-11-03 |
| Street Address |
901 RANCHO LN STE 135 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-3826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982816989 | Nathan J Cleveland | Emergency Medicine | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2007-05-04 |
| 1013545433 | William Chase Madsen | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-31 |
| 1447888219 | Lillian Paige Harry | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-29 |
| 1609404425 | Jared Miya | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-28 |
| 1689202434 | Jerad Dane Eldred | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-28 |
| 1770111619 | Jason Martinez | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-27 |
| 1043847585 | Joel Harris Schirding | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-25 |
| 1346877917 | Ahmad Ahssan Nezam | Student in an Organized Health Care Education/Training Program | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2020-03-24 |
| 1669010260 | Van Nguyen | Physician Assistant | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2019-12-13 |
| 1881232429 | Michael Choi | Physician Assistant | 901 Rancho Ln Ste 135, Las Vegas, NV 89106-3826 | 2019-12-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906440 | David Hernandez | Student in an Organized Health Care Education/Training Program | 1510 Grape Arbor Way, Las Vegas, NV 89142-0669 | 2020-09-10 |
| 1710591110 | Jessica Celestino | Student in an Organized Health Care Education/Training Program | 6167 Allen Cove Ct, Las Vegas, NV 89148-1799 | 2020-09-02 |
| 1972127314 | Toyokazu Endo | Student in an Organized Health Care Education/Training Program | 2040 W Charleston Blvd Fl 3, Las Vegas, NV 89102-2227 | 2020-06-01 |
| 1962025775 | William Taylor Gravley | Student in an Organized Health Care Education/Training Program | 1510 Ruby Cliffs Ln Unit 204, Las Vegas, NV 89144-7015 | 2020-05-27 |
| 1477174449 | Vishnu Halthore | Student in an Organized Health Care Education/Training Program | 2152 Turquoise Ridge St Unit 205, Las Vegas, NV 89117-5972 | 2020-05-01 |
| 1417576869 | Jesus Mendez Jr. | Student in an Organized Health Care Education/Training Program | 10962 Pentland Downs St, Las Vegas, NV 89141-3997 | 2020-04-15 |
| 1124657333 | Daniel Gerardo Arias | Student in an Organized Health Care Education/Training Program | 700 Shadow Ln Ste 400, Las Vegas, NV 89106-4159 | 2020-04-08 |
| 1659900959 | Connor Wayman | Student in an Organized Health Care Education/Training Program | 6655 S Cimarron Rd, Las Vegas, NV 89113-2180 | 2020-04-07 |
| 1700413887 | Sameera Baig | Student in an Organized Health Care Education/Training Program | 2880 N. Tenaya Way, Las Vegas, NV 89128-0431 | 2020-03-26 |
| 1457988537 | Wesley Washington Yim | Student in an Organized Health Care Education/Training Program | 657 N Town Center Dr Ofc, Las Vegas, NV 89144-6367 | 2020-03-26 |
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| 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.