Amwallace, LLC

NPI #1174802631 in Longview, Texas

Provider Information

NPI Number: 1174802631
Entity Type: Organization
Organization Name: Amwallace, LLC
Primary Specialty: Optometrist
Enumeration Date: Aug 15, 2011
Last Updated: Mar 25, 2020

Practice Location

Address: 3032 N EASTMAN RD STE 100
City: Longview
State: Texas
ZIP Code: 75605-5024
Phone: (903) 663-2020

Authorized Official

Name: MR. AUGUST MICHAEL WALLACE, OD
Title: DOCTOR/OWNER
Phone: (903) 663-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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