Doctor profile · Federal record
Dr. Charles Wallace, MD
Plastic and Reconstructive Surgery Physician (CMS: Plastic and Reconstructive Surgery) · Dallas, TX
- NPI 1164422481
- Accepts Medicare
- 44 yrs in practice
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
17110 Dallas Pkwy, Suite 100
Dallas, TX 752481167
(972) 380-7090
fax (972) 380-7016
Credentials & registration
- NPI registered
- July 2005 — 21 yrs on file
- Profile last updated
- July 14, 2010
- Year of graduation
- 1982 — 44 yrs since
- Specialty taxonomy
- 2086S0122X — NUCC code
- State license (1)
- Texas #G3885
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1164422481. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$407
Transactions
8
Manufacturers
3
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Abbvie INC. | 5 | $306.24 | |
| Integra LifeSciences Corporation | 2 | $76.37 | |
| Innovation Technologies INC | 1 | $24.34 |
By nature of payment
Frequently asked questions
What is Dr. Charles Wallace's medical specialty?
Dr. Charles Wallace practices Plastic and Reconstructive Surgery Physician in Dallas, TX.
Where does Dr. Charles Wallace practice?
Dr. Charles Wallace practices at 17110 Dallas Pkwy, Dallas, TX 752481167. Office phone: 9723807090.
What is Dr. Charles Wallace's NPI?
Dr. Charles Wallace's National Provider Identifier (NPI) is 1164422481, issued by NPPES.
Does Dr. Charles Wallace accept Medicare assignment?
Yes. Dr. Charles Wallace accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.