Wallace Sports Medicine PA

NPI #1770823213 in Rockwall, Texas

Provider Information

NPI Number: 1770823213
Entity Type: Organization
Organization Name: Wallace Sports Medicine PA
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Feb 20, 2013
Last Updated: Mar 27, 2013

Practice Location

Address: 2313 RIDGE RD STE 105B
City: Rockwall
State: Texas
ZIP Code: 75087-5141
Phone: (972) 722-4830

Authorized Official

Name: DR. JEFFREY WALLACE, MD
Title: PRESIDENT
Phone: (972) 722-4830

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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