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Brian Wallace, NP
Primary Care Nurse Practitioner in Tyler, Texas
NPI 1457561615

Brian Wallace is a Primary Care Nurse Practitioner based in Tyler, TX and is specialized in Primary Care. Brian Wallace practices in Tyler, TX and has the professional credentials of NP. The NPI Number for Brian Wallace is 1457561615 and holds a License No. RN 169685C (Texas).

The current practice location address for Brian Wallace is 1910 Roseland Blvd, Tyler, TX and can be reached out via phone at 903-533-0644.

Location: 1910 Roseland Blvd, Tyler, TX, 75701-4246
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Provider Profile Details
NPI Number
1457561615
Provider Name
Brian Wallace
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
1910 Roseland Blvd, Tyler, TX, 75701-4246
Phone Number
903-533-0644
Fax Number
Provider Enumeration Date
05/23/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1910 Roseland Blvd
City
State
Zip
75701-4246
Phone Number
903-533-0644
Fax Number
person
Provider Business Mailing Address Details
Address
1910 Roseland Blvd
City
State
Zip
75701-4246
Phone Number
903-533-0644
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
RN 169685C (Colorado)
Definition
Definition to come...
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