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

Michael Shawn Wallace, PHARMACIST

Individual provider Pharmacist · NPI 1659031052

Michael Shawn Wallace, PHARMACIST is a Pharmacist in Tyler, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2021
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Practice location Address checks out

4285 Chandler Hwy
Tyler, TX 75702-7604
Phone: (903) 630-9250
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 32751 (TX)

Record details

NPI number1659031052
Entity typeIndividual (Type 1)
GenderMale
Credentials PHARMACIST
Sole proprietorYes
NPI enumeratedDecember 27, 2021
Last updated in NPPESDecember 27, 2021
Certification dateDecember 27, 2021
Mailing address4285 Chandler Hwy, Tyler, TX 75702-7604

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