Jeanne B Wallace
CHAMPION ANESTHESIA CONSULTANTS PLLC


Address: 1545 E Southlake Blvd, Southlake, TX 76092-6422
Phone: 8177488700

Jeanne B Wallace (NPI# 1164408043, PAC ID# 5991695074) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ANESTHESIOLOGY.

Physician Overview

Nation Provider ID (NPI) 1164408043
PAC ID by PECOS 5991695074
Professional Enrollment ID I20040319001433
Full Name Jeanne B Wallace
Organization Legal Name CHAMPION ANESTHESIA CONSULTANTS PLLC
Address 1545 E Southlake Blvd
Southlake
TX 76092-6422
Phone Number 8177488700
Gender F
Credential MD
Graduation Year 1983
Primary Specialty ANESTHESIOLOGY
Group Practice PAC ID 7113231358
Number of Group Practice Members 18
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
450883 BAYLOR MEDICAL CENTER AT TROPHY CLUB

Other Locations

Address Phone Organization
1545 E Southlake Blvd, Southlake, TX 76092-6422 8177488700 CHAMPION ANESTHESIA CONSULTANTS PLLC

Organization Information

Organization Legal Name CHAMPION ANESTHESIA CONSULTANTS PLLC
Physicians 12

Physicians with the same organization

Name Specialty Organization Address
Lisa C Chenault Certified Registered Nurse Anesthetist (crna) Champion Anesthesia Consultants Pllc 2850 E State Hwy 114, Trophy Club, TX 76262-5302
Gregory B Gaskin Ii Anesthesiology Champion Anesthesia Consultants Pllc 415 E Southlake Blvd, Suite 202, Southlake, TX 76092-6280
Michael L Gibson Anesthesiology Champion Anesthesia Consultants Pllc 2600 W Pleasant Run Rd, Lancaster, TX 75146-1114
Christine C Wyrick Anesthesiology Champion Anesthesia Consultants Pllc 1400 8th Ave, Fort Worth, TX 76104-4110
David B Serota Anesthesiology Champion Anesthesia Consultants Pllc 2600 W Pleasant Run Rd, Lancaster, TX 75146-1114
Jonathon S Scarborough Certified Registered Nurse Anesthetist (crna) Champion Anesthesia Consultants Pllc 415 E Southlake Blvd, Suite 202, Southlake, TX 76092-6280
Timothy T Tye Anesthesiology Champion Anesthesia Consultants Pllc 11970 N Central Expy, Suite 610, Dallas, TX 75243-3768
Robert M Lagon Anesthesiology Champion Anesthesia Consultants Pllc 1351 W President George Bush Hwy, Richardson, TX 75080-1133
Joseph V Nicolosi Anesthesiology Champion Anesthesia Consultants Pllc 2850 E State Hwy 114, Trophy Club, TX 76262-5302
John L Thorne Anesthesiology Champion Anesthesia Consultants Pllc 11990 N Central Expressway, Dallas, TX 75243-3714

Office Location

Street Address 1545 E SOUTHLAKE BLVD
City SOUTHLAKE
State TX
Zip 76092-6422

Physicians in the same location

Name Specialty Organization Address
Maria Valeria Simone General Surgery 1545 E Southlake Blvd, Suite 140, Southlake, TX 76092-6464
Peter C Kwong Orthopedic Surgery 1545 E Southlake Blvd, Suite 270, Southlake, TX 76092-5564
Gayle M Jasinski Physician Assistant Texas Health Back Care 1545 E Southlake Blvd, Southlake, TX 76092-6422
Peter J Gootos Anesthesiology U S Anesthesia Partners of Texas, Pa 1545 E Southlake Blvd, Southlake, TX 76092-6422
Theresa Menditto Physical Therapy Texas Health Back Care 1545 E Southlake Blvd, Suite 100, Southlake, TX 76092-6465
Tristan Boyd Physical Therapy Texas Health Back Care 1545 E Southlake Blvd, Suite 100, Southlake, TX 76092-6465
Frederic James Hwang Anesthesiology U S Anesthesia Partners of Texas, Pa 1545 E Southlake Blvd, Southlake, TX 76092-6422
Elizabeth Chandy Internal Medicine 1545 E Southlake Blvd, Southlake, TX 76092-6422
David S Ackerman Anesthesiology U S Anesthesia Partners of Texas, Pa 1545 E Southlake Blvd, Southlake, TX 76092-6422
Paul Y Youn Anesthesiology U S Anesthesia Partners of Texas, Pa 1545 E Southlake Blvd, Southlake, TX 76092-6422
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Physicians in the same zip code

Name Specialty Organization Address
Carol A Marsh Optometry Marsh Eye Center Inc Marsh Eye Ctr, 670 East Southlake Blvd, Southlake, TX 76092
Branon Z Marsh Optometry Marsh Eye Center Inc Marsh Eye Ctr, 670 East Southlake Blvd, Southlake, TX 76092
Jerry L Lugger Plastic and Reconstructive Surgery 3061 W Southlake Blvd, Suite 130, Southlake, TX 76092-0311
Deborah J Zanella Optometry Zanella Optometry, Pllc 2111 E Kirkwood Blvd, 100 Kirkwood Eye Center, Southlake, TX 76092-1441
Alex R Conley Optometry Zanella Optometry, Pllc 2111 E Kirkwood Blvd, 100 Kirkwood Eye Center, Southlake, TX 76092-1441
Taylor R Brooks Optometry Zanella Optometry, Pllc 2111 E Kirkwood Blvd, 100 Kirkwood Eye Center, Southlake, TX 76092-1441
Peter J Zanella Jr. Optometry Zanella Optometry, Pllc 2111 E Kirkwood Blvd, 100 Kirkwood Eye Center, Southlake, TX 76092-1441
Rawn E Bosley Dermatology 925 E Southlake Blvd, Suite 200, Southlake, TX 76092-1476
Victoria A Lopez Physical Therapy Ideal Physical Therapy of Texas LLC 245 W State Hwy 114, Suite 320, Southlake, TX 76092-3603
Asif Husain General Surgery 190 W State Hwy 114, Suite G, Southlake, TX 76092-3612
Find all physicians in zip 76092

Competitor

Search similar physicians

City SOUTHLAKE
Zip Code 76092
Specialty ANESTHESIOLOGY
City + Specialty SOUTHLAKE + ANESTHESIOLOGY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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