MR. BENJAMIN LEVI WALLACE FNP-C NPI 1962913293

NPI Information

NPI: 1962913293
Provider Name: MR. BENJAMIN LEVI WALLACE, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
264 FM 3478 RD
HUNTSVILLE, TX
ZIP 77320
Phone: (936) 291-4200
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MR. Benjamin Levi Wallace, FNP-C is a family nurse practitioner in Huntsville, TX. MR. Benjamin Levi Wallace, FNP-C NPI is 1962913293. 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:

264 FM 3478 RD
HUNTSVILLE, TX
ZIP 77320-322
Phone: (936) 291-4200

The enumeration date for this NPI number is 10/13/2017 and was last updated on 10/13/2017.

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
1	363LF0000X	Nurse Practitioner	Family	AP134640	TEXAS	Yes

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: 4/28/2024

NPI Synchronization or Removal

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