Individual provider · Type 1 NPI

Jason R. Wallace, MD

Diagnostic Radiology Physician · Austin, TX

NPI number 1013028612 Active

Practice location

12554 Riata Vista Circle
Austin, TX 78727-6432

Call (512) 795-5100 Map

Fax (512) 795-5122

Specialties and licenses

TaxonomyCodeLicense
Body Imaging Physician 2085B0100XMD00046651 (WA)
Diagnostic Radiology Physician Primary 2085R0202XM9727 (TX)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1013028612

Jason R. Wallace, MD's National Provider Identifier is 1013028612, issued on Aug 31, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Austin, TX. The record was last updated on Feb 1, 2018.