| Doctor Name: | AMY E WALLACE |
| NPI Number: | 1144231499 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD, MPH |
| License Number: | 8845 |
| Business Practice Address: | 10141 Us 59 Hwy Wharton, TX - 774887224 |
| Business Phone Number: | 9792826137 |
| Business Fax Number: | 9792826840 |
| Mailing Address: | 10141 Us 59 Hwy, WHARTON |
| State: | TX |
| Postal Code: | 774887224 |
| Phone Number: | 9792826137 |
| Fax Number: | 9792826840 |
| NPI Enumeration Date: | 08/11/2006 |
| NPI Last Update Date: | 01/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0802X |
| License Number: | 8845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Psychiatry |
| Taxonomy Definition: | Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |