Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK WESLEY WALLIS, MD
Active Sole ProprietorJACK WESLEY WALLIS, MD is a Family Medicine healthcare provider located in SAN MARCOS, Texas. NPI 1962484733 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · SAN MARCOS, TX
Registration Details
- NPI Number
- 1962484733
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 17, 2005 (20.709428209644 yrs)
- Last Updated
- Sep 14, 2010
- Licenses
-
G8488 (TX)G8488 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2108 HUNTER RDSUITE 116SAN MARCOS, TX, 786665156Browse TX providers · Browse ZIP 78666
- Phone
- 5127547700
- Fax
- 5127540012
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Sports Medicine
Other Family Medicine Providers in SAN MARCOS, TX
| Name | Credential | NPI |
|---|---|---|
| JOHN RICHARD JACKSON | M.D. | 1457350902 |
| JENNIFER MARSHALL DRISKELL | MD | 1386634657 |
| GREGORY L COLON | MD | 1972594141 |
| RONALD RAY MCHOSE | D.O. | 1689645368 |
| DR. MARK B RANDOLPH | MD | 1982677209 |
| JACQUELINE SUE LIVINGSTON | DO | 1326004912 |
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.