Wallace, Patrick Joseph

Wallace, Patrick Joseph is an individual health care provider with primary practice located at 2240 Gulf Fwy S Ste 2.100 , League City TX 77573-5143. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Wallace, Patrick Joseph can be contacted via phone (832) 505-1800.

Contact Information

Primary practice address
2240 Gulf Fwy S Ste 2.100 League City TX 77573-5143
Phone: (832) 505-1800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X J7243 Texas
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X J7243 Texas
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X J7243 Texas

Profile Details

NPI number 1740219369
LBN Legal business name Wallace, Patrick Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Nov 21st, 2023 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1740219369 NPPES
Texas Other 8S4802 BLUE CROSS/BLUE SHIELD
Texas Other P00229401 BLUE CROSS/BLUE SHIELD
Texas MEDICAID 041937602 BLUE CROSS/BLUE SHIELD

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