RICHARD JAMES WALLACE MD NPI 1083698609

NPI Information

  • NPI: 1083698609
  • Provider Name: RICHARD JAMES WALLACE, MD
  • Classification: Internal Medicine - 207RI0200X
  • Specialization: Infectious Disease
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11937 US HIGHWAY 271
    TYLER, TX
    ZIP 75708
  • Phone: (903) 877-7777

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NPI Details

Richard James Wallace, MD is an infectious disease internal medicine in Tyler, TX. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. Richard James Wallace, MD NPI is 1083698609. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11937 US HIGHWAY 271
TYLER, TX
ZIP 75708-154
Phone: (903) 877-7777

The NPI 1083698609 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/6/2005 and was last updated on 10/21/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RI0200XInternal MedicineInfectious DiseaseD9705TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100861704MEDICAIDTEXAS
2806017MEDICARE ID-TYPE UNSPECIFIEDTEXAS
3C23113MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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