DR. MARK KOWALSKI WALLACE (NPI# 1548250103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548250103 |
| Entity Type | Individual |
| Full Name | DR. MARK KOWALSKI WALLACE |
| Credential | M.D |
| Practice Address |
3851 Roger Brooke Dr Ft Sam Houston San Antonio TX 78234 |
| Mailing Address |
12443 Tech Ridge Blvd #712 Austin TX 78753 |
| Practice Telephone | 2109160775 |
| Mailing Telephone | 2108187958 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
01053948A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538533005 | Mark Thomas Wallace | Speech-Language Pathologist | 2337 N 2nd St, Harrisburg, PA 17110-1009 | 2015-11-21 |
| 1942241096 | Mark Alan Wallace | Chiropractor | 2140 W Poplar Ave, Suite 107, Collierville, TN 38017-0624 | 2006-06-09 |
| 1669467213 | Mark Spangler Wallace | Dentist | 168 N 1950 W Ste 202, Salt Lake City, UT 84116-3007 | 2005-09-20 |
| 1932104205 | Mark Randall Wallace | Internal Medicine | 13400 E Shea Blvd, Scottsdale, AZ 85259 | 2005-06-14 |
| 1760753008 | Mark Edward Wallace | Psychiatry & Neurology | 77 7th Ave, #19d, New York, NY 10011-6645 | 2012-01-18 |
| 1205110434 | Mark James Wallace | Pharmacist | 301 S Sante Fe Ave, Edmond, OK 73003 | 2011-10-06 |
| 1932367539 | Mark Richard Wallace | Chiropractor | 9337 W 75th St, Overland Park, KS 66204 | 2008-05-30 |
| 1316119548 | Mark Steven Wallace | Hearing Instrument Specialist | 202 Grand Ave, Spencer, IA 51301 | 2008-03-27 |
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| 1104047190 | Mark C Wallace | Dentist | 50 County Road B E, Saint Paul, MN 55117-1927 | 2007-05-01 |
| Street Address |
3851 ROGER BROOKE DR FT SAM HOUSTON |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952747131 | Andrew Joseph Gausepohl | Emergency Medicine | 3851 Roger Brooke Dr, San Antonio, TX 78234-4501 | 2013-05-15 |
| 1306280227 | Amelia Lea Wilson | Occupational Therapist | 3851 Roger Brooke Dr, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX 78234-4501 | 2013-04-22 |
| 1588903488 | Paula Balderston | Social Worker | 3851 Roger Brooke Dr, San Antonio, TX 78234-4501 | 2013-02-12 |
| 1912279506 | Mark Steven Barrows | Nurse Anesthetist, Certified Registered | 3851 Roger Brooke Dr, San Antonio, TX 78234 | 2012-01-30 |
| 1588958615 | Marisa Rachel Gossweiler | Radiology | 3851 Roger Brooke Dr, San Antonio, TX 78234-4501 | 2011-06-07 |
| 1447558416 | Carlos Armando Mota | General Practice | 3851 Roger Brooke Dr, Fort Sam Houston, San Antonio, TX 78234-4501 | 2011-03-01 |
| 1457664922 | Edwin Gandia | Student in an Organized Health Care Education/Training Program | 3851 Roger Brooke Dr, Mche-qd, San Antonio, TX 78234-4501 | 2010-07-26 |
| 1467773556 | Steven Gremel Schauer | Emergency Medicine | 3851 Roger Brooke Dr, Department of Emergency Medicine, San Antonio, TX 78234-4501 | 2010-06-13 |
| 1831416197 | Charles Calais | Internal Medicine | 3851 Roger Brooke Dr, San Antonio, TX 78234-4501 | 2010-04-27 |
| 1649597113 | Bradley A Reel | Anesthesiology | 3851 Roger Brooke Dr, San Antonio, TX 78234-4501 | 2010-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003241837 | Insulin Rounds P A | Internal Medicine | 12951 Huebner Rd, #780355, San Antonio, TX 78278-7801 | 2013-09-11 |
| 1053549246 | Jeffrey Adam Colburn | Internal Medicine | Mche-mde 3551 Roger Brooke Dr, Brooke Army Medical Center, San Antonio, TX 78234-6200 | 2009-06-25 |
| 1023282746 | Dcoa Physician Associates Pa | Internal Medicine | 7863 Callaghan Road, Ste 206, San Antonio, TX 78229-2452 | 2008-04-14 |
| 1437328481 | Dcoa Physician Associates Pa | Internal Medicine | 3154 Se Military Dr, Suite 103, San Antonio, TX 78223-3974 | 2008-02-25 |
| 1043494826 | Jennifer M. Argumedo | Internal Medicine | 7355 Barlite Blvd Ste 401, San Antonio, TX 78224-1341 | 2007-12-28 |
| 1902086952 | Rafeeq A. Ali | Internal Medicine | 701 S Zarzamora St # Ms 3-5, San Antonio, TX 78207-5209 | 2007-11-07 |
| 1538370572 | Dcoa Physician Associates Pa | Internal Medicine | 20330 Huebner Road, Ste 104, San Antonio, TX 78258-3509 | 2007-05-24 |
| 1417968306 | Gloria L Ocampo | Internal Medicine | 4458 Medical Dr Ste 405, San Antonio, TX 78229 | 2006-08-10 |
| 1487636205 | Firas Akhrass | Internal Medicine | 5107 Medical Drive, San Antonio, TX 78229 | 2005-11-17 |
| 1396746442 | Jaime Oscar Cruz | Internal Medicine | 155 E Sonterra Blvd Ste 105, San Antonio, TX 78258-3988 | 2005-08-10 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78234 |
Please comment or provide details below to improve the information on DR. MARK KOWALSKI 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.