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

Jason R. Wallace, MD

Individual provider Body Imaging Physician · NPI 1013028612

Jason R. Wallace, MD is a Diagnostic Radiology in Austin, Texas. Graduated from University of Texas Medical Branch at Galveston in 2001, 25 years ago. Practices with Austin Radiological Association, a 123-clinician group and accepts Medicare assignment. Licensed in Texas and Washington.

Years since qualifying
25
Trained at
University of Texas Medical Branch at Galveston
Licensed in
TX, WA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12554 Riata Vista Cir
Austin, TX 78727-6432
Phone: (512) 795-5100
Fax: (512) 795-5122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence M9727 (TX)
Body Imaging Physician Taxonomy 2085B0100X · Licence MD00046651 (WA)

Record details

NPI number1013028612
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESFebruary 1, 2018
Mailing address12554 Riata Vista Circle, Austin, TX 78727-6432

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 2001 (25 years in practice)
Group practice Austin Radiological Association — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations18 on file with Medicare

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