National Provider Identifier Database

DAVID R WALLACE JR, MD – NPI #1265743595
Diagnostic Radiology

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


Contact Information

DAVID R WALLACE JR, MD
1800 RYAN ST STE 105
LAKE CHARLES, LA70601-6078
Phone: 337-439-4706
Fax: 337-439-8110
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X
Student in an Organized Health Care Education/Training Program 390200000X

* Indicates primary specialty

NPI Profile & details for DAVID R WALLACE JR

NPI Number 1265743595
Credentials MD
Entity Individual
Enumeration date 07/01/2010
Last updated 03/12/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • CA License #: A136122
  • LA License #: MD.204718
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for DAVID R WALLACE JR, MD

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