BRIAN WALLACE

TYLER, TX
NPI1457561615
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: CO  RN 169685c)
Enumeration Date2007-05-23
Last Update Date2010-03-12
Business Address
-- BRIAN WALLACE N.P.
1910 ROSELAND BLVD
TYLER, TX 75701-4246
Phone number: 903-533-0644
Mailing Address
-- BRIAN WALLACE N.P.
1910 ROSELAND BLVD
TYLER, TX 75701-4246
Phone number: 903-533-0644
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