Dr Patrick Joseph Wallace, MD | |
2240 Gulf Fwy S Ste 2.100, League City, TX 77573-5143 | |
(832) 505-1800 | |
Not Available |
Full Name | Dr Patrick Joseph Wallace |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 35 Years |
Location | 2240 Gulf Fwy S Ste 2.100, League City, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740219369 | NPI | - | NPPES |
8S4802 | Other | TX | BLUE CROSS/BLUE SHIELD |
P00229401 | Other | MEDICARE RAILROAD | |
041937602 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | J7243 (Texas) | Secondary |
2086X0206X | Surgery - Surgical Oncology | J7243 (Texas) | Secondary |
2086S0127X | Surgery - Trauma Surgery | J7243 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
University Of Texas Medical Branch Galveston | Galveston, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
University Of Texas Medical Branch Faculty Group Practice | 3375456734 | 883 |
Entity Name | Utmb Faculty Group Practice |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942241146 PECOS PAC ID: 3375456734 Enrollment ID: O20031112000438 |
Mailing Address | Practice Location Address |
---|---|
Dr Patrick Joseph Wallace, MD 2240 Gulf Fwy S Ste 2.100, League City, TX 77573-5143 Ph: (832) 505-1800 | Dr Patrick Joseph Wallace, MD 2240 Gulf Fwy S Ste 2.100, League City, TX 77573-5143 Ph: (832) 505-1800 |
Roman V Petrov, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2280 Gulf Fwy S, League City, TX 77573 Phone: 832-505-4000 | |
Charles Polsen, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2622 Marina Bay Drive, League City, TX 77573 Phone: 281-538-6600 Fax: 281-535-2800 | |
Sean Michael Brennan, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2240 Gulf Fwy S, League City, TX 77573 Phone: 409-772-1011 |