Individual provider · Type 1 NPI
David R. Wallace Jr., MD
Diagnostic Radiology Physician · Lake Charles, LA
NPI number
1265743595
Active
Practice location
1800 Ryan St Ste 105
Lake Charles, LA 70601-6078
Fax (337) 439-8110
Other practice locations
- 10310 The Grove Blvd, Baton Rouge, LA 70836-6455 · (225) 761-5200
- 1453 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105-6810 · (318) 798-4623
- 1455 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5634 · (318) 798-4500
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A136122 (CA) |
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Diagnostic Radiology Physician Primary | 2085R0202X | MD.204718 (LA) |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
3 other providers at this address
Other diagnostic radiology physician providers in Lake Charles
- John R. Romero Iii, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1063495612
- Richard L. Martinez, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1104809011
- Donald A. Woolridge, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1194748251
- Charles J. Brdlik, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1215910112
- Adam D. Olsan, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1245213164
- David R. McFarland, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1275511016
- George L. Miller Iii, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1285617191
- Jeremy M. Rau, MDDiagnostic Radiology Physician Lake Charles, LA NPI 1285894196
About NPI 1265743595
David R. Wallace Jr., MD's National Provider Identifier is 1265743595, issued on Jul 1, 2010. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Lake Charles, LA. The record was last updated on Mar 12, 2025.