Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRENT H WALLACE, M.D.
Deactivated Sole ProprietorDR. BRENT H WALLACE, M.D. is a Internal Medicine healthcare provider located in CLEBURNE, Texas. NPI 1386638252 is deactivated in the NPPES registry. Verify at CMS.
Internal Medicine · CLEBURNE, TX
This NPI has been deactivated.
The record was deactivated on March 24, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1386638252
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 7, 2005 (0.54246575342466 yrs)
- Last Updated
- Jul 8, 2007
- Deactivated
- Mar 24, 2006
- License
-
F2093 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
141 HYDE PARK BLVDCLEBURNE, TX, 760334561Browse TX providers · Browse ZIP 76033
- Phone
- 8176415221
- Fax
- 8175175241
- Primary Specialty
-
Internal Medicine
207R00000X
Other Internal Medicine Providers in CLEBURNE, TX
| Name | Credential | NPI |
|---|---|---|
| EDWARD E BATES | MD | 1639179013 |
| DR. ELENA GUROVA | M.D. | 1023002144 |
| DR. JOHN BAMIDELE DARAMOLA | MD | 1013995810 |
| DR. YVONNE JO REED | MD | 1740244136 |
| DR. ALBERT SEAN DALLEY | MD | 1164478194 |
| DR. SHOAIB KHALIL | M.D. | 1003857459 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.