JACK WESLEY WALLIS MD NPI 1962484733

NPI Details

Jack Wesley Wallis, MD is a family medicine in San Marcos, TX with 42 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jack Wesley Wallis, MD NPI is 1962484733. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year:1984

The provider's business location address is:

2108 HUNTER RD
SUITE 116
SAN MARCOS, TX
ZIP 78666-156
Phone: (512) 754-7700
Fax: (512) 754-0012

The NPI 1962484733 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• Test for allergy using allergenic extract injected into skin with delayed reaction analysis (HCPCS:95028)
• Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
• Administration of pneumococcal vaccine (HCPCS:G0009)
• Hemoglobin a1c level (HCPCS:83036)
• Pneumococcal vaccine, 13-valent (HCPCS:90670)
• Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment (HCPCS:G0402)
• Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 11/17/2005 and was last updated on 9/14/2010.

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:

Other Identifiers

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