DR. Brent H Wallace, M.D.

NPI #1386638252 in Cleburne, Texas

Provider Information

NPI Number: 1386638252
Entity Type: Individual
Name: DR. Brent H Wallace, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Internal Medicine
Credential: M.D.
Enumeration Date: Sep 7, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 141 HYDE PARK BLVD
City: Cleburne
State: Texas
ZIP Code: 76033-4561
Phone: (817) 641-5221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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