Wallace, Terry
Wallace, Terry is an individual health care provider with primary practice located at 605 Rockmead Dr Suite 200, Humble TX 77339-2254. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is his primary health care specialty. Wallace, Terry can be contacted via phone (281) 348-9588.Contact Information
Primary practice address
605 Rockmead Dr Suite 200
Humble TX 77339-2254
Phone: (281) 348-9588
Fax: (281) 348-2150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 104330 | Texas |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand | 225XH1200X | 1041100564 | Texas |
Profile Details
| NPI number | 1639112071 |
|---|---|
| LBN Legal business name | Wallace, Terry |
| Credentials | LOT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Feb 10th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639112071 | NPPES |
| Texas | Other | 104330 | OCCUPATIONAL THERAPY LICENSE |
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