person
Craigreon Levar Wallace, PA
Medical Physician Assistant in Dallas, Texas
NPI 1952386815

Craigreon Levar Wallace is a Medical Physician Assistant based in Dallas, TX and is specialized in Medical. Craigreon Levar Wallace practices in Dallas, TX and has the professional credentials of PA. The NPI Number for Craigreon Levar Wallace is 1952386815 and holds a License No. PA06903 (Texas).

The current practice location address for Craigreon Levar Wallace is 6201 Harry Hines Blvd, Dallas, TX and can be reached out via phone at 214-648-3111.

Location: 6201 Harry Hines Blvd, Dallas, TX, 75284-7208
person
Provider Profile Details
NPI Number
1952386815
Provider Name
Craigreon Levar Wallace
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
6201 Harry Hines Blvd, Dallas, TX, 75284-7208
Phone Number
214-648-3111
Fax Number
Provider Enumeration Date
12/13/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
6201 Harry Hines Blvd
City
State
Zip
75235
Phone Number
214-648-3111
Fax Number
person
Provider Business Mailing Address Details
Address
6201 Harry Hines Blvd
City
State
Zip
75235
Phone Number
214-648-3111
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA06903 (Texas)
Definition
Definition to come...
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