Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Craigreon Levar Wallace, PA

Individual provider Medical Physician Assistant · NPI 1952386815

Craigreon Levar Wallace, PA is a Physician Assistant in Dallas, Texas. Qualified in 2005, 21 years ago. Practices with University of Texas Southwestern Medical Center at Dallas, a 3,149-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
21
Licensed in
TX
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

6201 Harry Hines Blvd
Dallas, TX 75235
Phone: (214) 648-3111
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

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA06903 (TX)

Record details

NPI number1952386815
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 13, 2005
Last updated in NPPESAugust 29, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice University Of Texas Southwestern Medical Center At Dallas — 3149 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Dallas