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

Dr. Jesse Wallace, PHD

Individual provider Marriage & Family Therapist · NPI 1154278497

Dr. Jesse Wallace, PHD is a Marriage and Family Therapist in Nolanville, Texas. Qualified in 2020, 6 years ago. Practices as a sole proprietor. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2026
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

2010 Bluff Dr
Nolanville, TX 76559-0050
Phone: (760) 443-7154
Show map & directions

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

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 206370 (TX)

Record details

NPI number1154278497
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedMarch 16, 2026
Last updated in NPPESMarch 16, 2026
Certification dateMarch 15, 2026
Mailing address2010 Bluff Dr, Nolanville, TX 76559-0050

Medicare enrollment

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

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated