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

Dr. Lee Travis Wallace, PHD

Individual provider Clinical Psychologist · NPI 1649286949

Dr. Lee Travis Wallace, PHD is a Clinical Psychologist in Austin, Texas. Qualified in 1980, 46 years ago. Accepts Medicare assignment. Licensed in Texas.

Years since qualifying
46
Licensed in
TX
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

13740 Hwy 183 #R-3
Austin, TX 78750
Phone: (512) 331-1415
Fax: (512) 918-2325
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 22772 (TX)

Record details

NPI number1649286949
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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