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

Eli William Wallace, OT

Individual provider Occupational Therapist · NPI 1891538070

Eli William Wallace, OT is an Occupational Therapist in Private Practice in Lafayette, Louisiana. Qualified in 2014, 12 years ago. Practices with Louisiana Physical Therapy Services of Lafayette, LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
12
Licensed in
LA
In the registry since
2024
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

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Practice location Address checks out

400 Polly Ln
Lafayette, LA 70508-4966
Phone: (337) 443-0652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OTT.200733 (LA)

Record details

NPI number1891538070
Entity typeIndividual (Type 1)
GenderMale
Credentials OT
Sole proprietorNo
NPI enumeratedJune 17, 2024
Last updated in NPPESJune 17, 2024
Certification dateJune 16, 2024
Mailing address105 Concerto Crst, Duson, LA 70529-3352

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Louisiana Physical Therapy Services Of Lafayette, Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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