Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Brian Wallace, NP

Individual provider Primary Care Nurse Practitioner · NPI 1457561615

Brian Wallace, NP is a Nurse Practitioner in Tyler, Texas. Qualified in 2007, 19 years ago. Practices with Intermountain Medical Group Denver LLC, a 567-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado.

Years since qualifying
19
Licensed in
CO
In the registry since
2007
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1910 Roseland Blvd
Tyler, TX 75701-4246 Not confirmed with CMS for 16 years — call before visiting
Phone: (903) 533-0644
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence RN 169685C (CO)

Record details

NPI number1457561615
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedMay 23, 2007
Last updated in NPPESMarch 12, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Intermountain Medical Group Denver Llc — 567 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients54
Services billed 197 a service is one billed item, such as a visit, a test or a procedure
Average patient age65

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Intermountain Medical Group Denver LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 567 clinicians in the practice; 12 are shown here.

Other providers in Tyler