Wallace, David R

Wallace, David R is an individual health care provider with primary practice located at 1800 Ryan St Ste 105 , Lake Charles LA 70601-6078. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wallace, David R can be contacted via phone (337) 439-4706.

Contact Information

Primary practice address
1800 Ryan St Ste 105 Lake Charles LA 70601-6078
Phone: (337) 439-4706
Fax: (337) 439-8110
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A136122 California
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD.204718 Louisiana

Profile Details

NPI number 1265743595
LBN Legal business name Wallace, David R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2010
Last updated Sep 20th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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