Bridgett D'Ann Wallace in Austin - Neurology
Bridgett D'Ann Wallace - NPI 1063451375
Bridgett D'Ann Wallace is a Neurology in Austin, Texas. Bridgett D'Ann Wallace practices all healthcare services and medical treatments related to Neurology. The NPI Number for Bridgett D'Ann Wallace is 1063451375. The last update date is 2019-01-31.
Bridgett D'Ann Wallace's current location address is 5608 Parkcrest Dr, Austin, Texas. You can contact this provider via phone number 5123454664 and fax number 5123456150. The mailing address for Bridgett D'Ann Wallace is 5608 Parkcrest Dr, Austin, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bridgett D'Ann Wallace |
|---|---|
| Address | 5608 Parkcrest Dr, Austin, Texas |
| Phone Number | 5123454664 |
| Fax Number | 5123456150 |
| Sole Proprietor | X |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1063451375 |
|---|---|
| Provider Enumeration Date | 2006-06-05 |
| Last Updated Date | 2019-01-31 |
Provider Mailing Address Detail
| Address | 5608 Parkcrest Dr |
|---|---|
| City | Austin |
| State | Texas (TX) |
| Post Code | 787314972 |
| Phone Number | 5123454664 |
| Fax Number | 5123456150 |
Provider's Primary Taxonomy Detail
| Speciality | Neurology |
|---|---|
| Taxonomy | 2251N0400X |
| Licence No | 1104610 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Neurologic Physical Therapy, who has demonstrated specialized knowledge and skill in neuroanatomy and neurophysiology, including knowledg |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 86683T | TX | BCBS INDIVIDUAL # | |
| 0050HV | TX | BCBS GROUP # | |
| 30384821 | TX | PHCS PROVIDER # | |
| 30384821 | TX | TEXAS TRUE CHOICE | |
| 30384821 | TX | HUMANA |
Post Comment/ Review Below
What is the Bridgett D'Ann Wallace's 1063451375?
The Bridgett D'Ann Wallace's NPI (National Provider Identifier) Number is 1063451375. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Bridgett D'Ann Wallace is physically located?
The Bridgett D'Ann Wallace is situated at the following address: 5608 Parkcrest Dr, Austin, TX 787314972.
What is Bridgett D'Ann Wallace's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Bridgett D'Ann Wallace is Neurology, and the taxonomy code that categorizes this field of expertise is 2251N0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1063451375 to Bridgett D'Ann Wallace?
The Centers for Medicare & Medicaid Services assigned the 1063451375 to Bridgett D'Ann Wallace on 2006-06-05.
As of what date were the details related to Bridgett D'Ann Wallace most recently updated or revised?
The information pertaining to Bridgett D'Ann Wallace, including its address, specialty, and other relevant details, was last updated or revised on 2019-01-31.
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