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Jason R. Wallace, MD
Diagnostic Radiology Physician in Austin, Texas
NPI 1013028612

Jason R. Wallace is a Diagnostic Radiology Physician based in Austin, TX and is specialized in Diagnostic Radiology. Jason R. Wallace practices in Austin, TX and has the professional credentials of MD. The NPI Number for Jason R. Wallace is 1013028612 and holds a License No. MD00046651 (Texas).

The current practice location address for Jason R. Wallace is 12554 Riata Vista Circle, Austin, TX and can be reached out via phone at 512-795-5100 and via fax at 512-795-5122.

Location: 12554 Riata Vista Circle, Austin, TX, 78727-6432
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013028612
Provider Name
Jason R. Wallace
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
12554 Riata Vista Circle, Austin, TX, 78727-6432
Phone Number
512-795-5100
Fax Number
512-795-5122
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
12554 Riata Vista Circle
City
Austin
State
Texas
Zip
78727-6432
Phone Number
512-795-5100
Fax Number
512-795-5122
person
Provider Business Mailing Address Details
Address
12554 Riata Vista Circle
City
Austin
State
Texas
Zip
78727-6432
Phone Number
512-795-5100
Fax Number
512-795-5122
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Body Imaging
Taxonomy
2085B0100X
License No.
M9727 (Texas)
Definition
A Radiology doctor of Osteopathy that specializes in Body Imaging.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
MD00046651 (Washington)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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