NPI age
20 years
Enumerated 2005-07-28
● Active
Type 1 · Individual
Charles Alan Wallace, MD
Wallace is 1 of 76 surgery providers in Dallas and 1 of 548 in Texas.
Primary specialty
Surgery
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2010-07-14
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 548 active surgery providers in Texas.
NPI age
20 years
↑ 3 yr above median (17 yr)
State licenses
1 state
15% of peers hold multiple states
Subspecialties
0
40% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-07Enumerated in NPPES
2005
2026
Where they practice
Practice location
17110 Dallas Pkwy, Suite 100
Dallas, TX 752481167
Mailing address
17110 Dallas Pkwy, Suite 100
Dallas, TX 752481167
Specialties
-
Surgery PrimaryA surgeon who specializes in plastic and reconstructive surgery.
Practice context
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.