Individual provider · Type 1 NPI
Allen Wallace
Private Vehicle · Lubbock, TX
NPI number
1417683293
Active
Practice location
3506 E 14th St
Lubbock, TX 79403-6207
Mailing address
6923 Indiana Ave # 335
Lubbock, TX 79413-6111
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver | 172A00000X | 22954496 (TX) |
| Private Vehicle Primary | 347C00000X | 22954496 (TX) |
Private Vehicle: An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
About NPI 1417683293
Allen Wallace's National Provider Identifier is 1417683293, issued on Jul 25, 2022. The primary taxonomy on file is Private Vehicle (347C00000X), and the practice location is in Lubbock, TX. The record was last updated on Jan 10, 2023.