Allen Wallace is a Private Vehicle based in Lubbock, TX. Allen Wallace practices in Lubbock, TX. The NPI Number for Allen Wallace is 1417683293 and holds a License No. 22954496 (Texas).
The current practice location address for Allen Wallace is 3506 E 14Th St, Lubbock, TX and can be reached out via phone at 806-777-3607.
Location: 3506 E 14Th St, Lubbock, TX, 79413-6111
Provider Profile Details
NPI Number
1417683293
Provider Name
Allen Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
3506 E 14Th St, Lubbock, TX, 79413-6111
Phone Number
806-777-3607
Fax Number
Provider Enumeration Date
07/25/2022
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417683293 | 05 | TX |
Provider Business Practice Location Address Details
Address
3506 E 14Th St
City
State
Zip
79403-6207
Phone Number
806-777-3607
Fax Number
Provider Business Mailing Address Details
Address
3506 E 14Th St
City
State
Zip
79403-6207
Phone Number
806-777-3607
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
22954496 (Texas)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
Provider's Taxonomy Details 2
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
License No.
22954496 (Texas)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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