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1386648228
TED W WALLIS
AUSTIN, TX
NPI
1386648228
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: TX E6677)
Enumeration Date
2005-06-09
Last Update Date
2009-06-18
Business Address
Dr. TED W WALLIS MD
4007 JAMES CASEY ST STE B200
AUSTIN, TX 78745-1181
Phone number: 512-441-9799
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Mailing Address
Dr. TED W WALLIS MD
203 WALLIS DR
AUSTIN, TX 78746-4637
Phone number: 512-329-9459
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