JAMES KENNETH WALLACE

LONGVIEW, TX
NPI1912014838
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  228579)
Enumeration Date2006-08-24
Last Update Date2012-06-04
Business Address
Mr. JAMES KENNETH WALLACE CRNA
703 E MARSHALL AVE SUITE 2000
LONGVIEW, TX 75601-5500
Phone number: 903-315-5300
Mailing Address
Mr. JAMES KENNETH WALLACE CRNA
195 W 1ST ST
RUSK, TX 75785-1201
Phone number: 903-683-2676
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