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

Kody Wallace

Individual provider Physical Therapist · NPI 1912061607

Kody Wallace is a Physical Therapist in Mineral Wells, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2006
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Practice location Address checks out

400 SW 25th Ave
Mineral Wells, TX 76067-8246
Phone: (940) 328-6580
Fax: (940) 328-6550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1141471 (TX)

Record details

NPI number1912061607
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 20, 2006
Last updated in NPPESJuly 8, 2007
Mailing address705 N Murco Dr, Mineral Wells, TX 76067-9008

Other providers in Mineral Wells