Wallis, Ted W

Wallis, Ted W is an sole proprietor health care provider with primary practice located at 4007 James Casey St Ste B200 , Austin TX 78745-1181. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wallis, Ted W can be contacted via phone (512) 441-9799.

Contact Information

Primary practice address
4007 James Casey St Ste B200 Austin TX 78745-1181
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X E6677 Texas

Profile Details

NPI number 1386648228
LBN Legal business name Wallis, Ted W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2005
Last updated Jun 18th, 2009 - about 15 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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