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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. CODY LEE WALLS, ATC, LAT, EMT

Active Sole Proprietor

MR. CODY LEE WALLS, ATC, LAT, EMT is a Athletic Trainer healthcare provider located in TEXARKANA, Texas. NPI 1821341447 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · TEXARKANA, TX

Registration Details

NPI Number
1821341447
Provider Type
Individual
Gender
Male
NPI Issued
Oct 19, 2012 (13.801124751168 yrs)
Last Updated
Oct 19, 2012
Licenses
168141 (TX)
22756 (AR)
1634643 (TX)
AT4598 (TX)
Sole Proprietor
Yes

Practice Information

Address
4001 SUMMERHILL RD
TEXARKANA, TX, 755032764
Browse TX providers · Browse ZIP 75503
Phone
9037943891
Primary Specialty
Athletic Trainer
2255A2300X
Additional Specialty
Health Educator
Additional Specialty
Athletic Trainer

Other Athletic Trainer Providers in TEXARKANA, TX

Name Credential NPI
FORESTT BRIDGES 1669924726
HANNAH FITCH 1124513502
STEPHANIE MICHELLE SCOTT LAT 1952886905
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.