Wallace, Charles Alan

Wallace, Charles Alan is an sole proprietor health care provider with primary practice located at 17110 Dallas Pkwy Suite 100, Dallas TX 75248-1167. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Wallace, Charles Alan can be contacted via phone (972) 380-7090.

Contact Information

Primary practice address
17110 Dallas Pkwy Suite 100 Dallas TX 75248-1167
Phone: (972) 380-7090
Fax: (972) 380-7016
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X G3885 Texas

Profile Details

NPI number 1164422481
LBN Legal business name Wallace, Charles Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2005
Last updated Jul 14th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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