WALLACE ORTHOPAEDICS AND SPORTS MEDICINE (NPI# 1740306208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740306208 |
| Entity Type | Organization |
| Organization Name | WALLACE ORTHOPAEDICS AND SPORTS MEDICINE |
| Practice Address |
6701 Heritage Pkwy Suite 140 Rockwall TX 75087-8747 |
| Practice Telephone | 9724631253 |
| Practice Fax Number | 9724630758 |
| Mailing Telephone | 9724631253 |
| Mailing Fax Number | 9724630758 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JEFFREY S WALLACE (PRESIDENT) |
| Authorized Official Telephone | 9724631253 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | J3932 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
6701 HERITAGE PKWY SUITE 140 |
| City | ROCKWALL |
| State | TX |
| Zip Code | 75087-8747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992709620 | Walter L Taylor IIi | Specialist | 6701 Heritage Pkwy, Ste 110, Rockwall, TX 75087-8799 | 2005-06-10 |
| 1922558477 | Krista Toliver | Nurse Practitioner | 6701 Heritage Pkwy, Suite 110, Rockwall, TX 75087-8747 | 2016-10-08 |
| 1235587460 | Jessica Kuehn | Marriage & Family Therapist | 6701 Heritage Pkwy, 170, Rockwall, TX 75087-8747 | 2016-05-27 |
| 1740648146 | Nicole Everett | Counselor | 6701 Heritage Pkwy, Suite #170, Rockwall, TX 75087-8747 | 2016-02-01 |
| 1912316332 | Frisco Spine, P.a. | Neurological Surgery | 6701 Heritage Pkwy, Suite 165, Rockwall, TX 75087-8747 | 2014-08-11 |
| 1669734018 | David L. Miller, D,d.s., Pa | Dentist | 6701 Heritage Pkwy, Suite 120, Rockwall, TX 75087-8799 | 2012-06-12 |
| 1629227855 | Henrik Mike-mayer, Md, Pa | Clinic/Center | 6701 Heritage Pkwy, Rockwall, TX 75087-8747 | 2008-09-11 |
| 1376716837 | Delano S Fabro Jr Do Pa | Internal Medicine | 6701 Heritage Pkwy, Suite 130, Rockwall, TX 75087-8747 | 2008-04-05 |
| 1427269802 | Carol Kitay Villanueva | Internal Medicine | 6701 Heritage Pkwy, Ste 160, Rockwall, TX 75087-8747 | 2007-05-25 |
| 1760604508 | Delano S Fabro Jr. | Internal Medicine | 6701 Heritage Pkwy, Suite 130, Rockwall, TX 75087-8747 | 2007-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104452309 | Schweers Dental Pllc | Clinic/Center | 3005 N Goliad St., Suite 110, Rockwall, TX 75087 | 2020-03-19 |
| 1467091611 | Elsa Varughese | Nurse Practitioner | 414 Garrett Dr, Rockwall, TX 75087 | 2020-01-04 |
| 1578105391 | Jaya Raji Mathai | Psychiatry & Neurology | 2249 Ridge Rd., Rockwall, TX 75087 | 2019-10-14 |
| 1104326784 | Eunice B Ontita | Nurse Practitioner | 601 White Hills Dr., Suite 100, Rockwall, TX 75087 | 2018-02-20 |
| 1053811885 | Emelda Fehnyui Ndinjiakat | Licensed Vocational Nurse | 610 Louder Way, Fate, TEXAS 75087 | 2018-02-19 |
| 1588163885 | January Lauren Green | Nurse Practitioner | 6800 Heritage Parkway, Suite 201, Rockwall, TX 75087 | 2018-02-02 |
| 1093268328 | Anouk Family Chiropractic, Pllc | Chiropractor | 2555 Ridge Rd #150, Rockwall, TX 75087 | 2016-08-03 |
| 1962858134 | Katherine L. Crane | Counselor | 302 W. Kaufman St., Rockwall, TX 75087 | 2016-05-06 |
| 1669841102 | Richard Carroll Smith | Obstetrics & Gynecology | 2120 Clubview, Rockwall, TX 75087 | 2015-09-15 |
| 1033598032 | Michelle Knight | Massage Therapist | 767 Justin Rd, Rockwall, TX 75087 | 2015-05-22 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770823213 | Wallace Sports Medicine Pa | Orthopaedic Surgery | 2313 Ridge Rd Ste 105b, Rockwall, TX 75087-5141 | 2013-02-20 |
| 1730475542 | Joshua Acree | Orthopaedic Surgery | 3136 Horizon Rd Ste 100, Rockwall, TX 75032 | 2011-06-21 |
| 1093987042 | R Mark Hazel Pa | Orthopaedic Surgery | 6701 Heritage Pkwy Ste 170, Rockwall, TX 75087-8798 | 2008-03-31 |
| 1962512491 | Craig R Duhon | Orthopaedic Surgery | 3136 Horizon Rd, Suite 100, Rockwall, TX 75032-7807 | 2006-08-30 |
| 1629089156 | Jeffrey S Wallace | Orthopaedic Surgery | 6800 Heritage Pkwy Ste 102, Rockwall, TX 75087-8746 | 2006-08-10 |
| 1932131398 | Mohammad Umar Burney | Orthopaedic Surgery | 1301 Summer Lee Drive, Rockwall, TX 75032 | 2006-07-07 |
| 1700869997 | Theodore Andrew Belanger | Orthopaedic Surgery | 3164 Horizon Rd, Suite 100, Rockwall, TX 75032-7805 | 2005-11-22 |
| 1013285758 | Anton Vladimir Zaryanov | Orthopaedic Surgery | 3142 Horizon Rd Ste 100, Rockwall, TX 75032-7815 | 2011-12-08 |
| 1467783027 | Dr. Michael Duchamp Do, Pa | Orthopaedic Surgery | 930 W Ralph Hall Pkwy, Suite 108, Rockwall, TX 75032-6665 | 2010-01-21 |
| 1821329566 | Joel Philip Zarling | Orthopaedic Surgery | 3136 Horizon Rd, Ste 100, Rockwall, TX 75032-7808 | 2010-01-20 |
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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.