Tracy Wallace
MD | Pediatrics | Female
Tracy Wallace, MD is a Gonzales, Louisiana based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Tracy Wallace is
1937 S Burnside Ave, Gonzales, Louisiana - 70737-4632. She can be contacted on phone at
225-765-5500 and fax number 225-644-9286.
Tracy Wallace is a sole proprietor of her business.
NPI number (Unique professional ID) for Tracy Wallace is
1720306558 which was assigned by NPPES on 04 May, 2010 and it was last updated on 19 May, 2021.
Tracy Wallace license number is
204717 for Pediatrics (208000000X) in Louisiana.
Tracy Wallace is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Tracy Wallace basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Tracy Wallace |
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| Credential : | MD |
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| Gender : | Female |
|---|
Business Address:
Tracy Wallace address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1937 S Burnside Ave
Gonzales, LA, 70737-4632
United States |
|---|
| Phone Number : | 225-765-5500 |
|---|
| Fax Number : | 225-644-9286 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1720306558 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 04 May, 2010 |
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| Last Updated On : | 19 May, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tracy Wallace are as mentioned. Primary taxonomy code for Tracy Wallace, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 204717 | LA |
Legacy Identifiers:
Other legacy medical identifiers of Tracy Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 2103831 | MEDICAID | LA | |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | twallace7489@direct.casso.us.com
FMOLHS-Epic | No affiliation | DIRECT
Direct
| OTHER
Other
twallace7489@direct.casso.us.com | 1937 S BURNSIDE AVE,
GONZALES, LA, 70737-4632
United States |
FHIR
(FHIR URL) | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
FMOLHS FHIR URL | No affiliation | OTHER
Other
FHIR API | OTHER
Other
C-CDA | 1937 S BURNSIDE AVE,
GONZALES, LA, 70737-4632
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 5959 S Sherwood Forest Blvd
Baton Rouge, LA, 70816-6038
United States |
|---|
| Phone Number : | 225-765-5727 |
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| Fax Number : | 225-765-9196 |
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Business Location:
Patients can refer following map for directions to
Tracy Wallace practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.