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

Michael Wallace

Individual provider Physical Therapy Assistant · NPI 1609356864

Michael Wallace is a Physical Therapy Assistant in San Angelo, Texas. Licensed in Texas. Registered with an NPI since 2018.

Licensed in
TX
In the registry since
2018
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Practice location Address checks out

5455 Knickerbocker Rd
San Angelo, TX 76904-7711
Phone: (325) 944-1600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2027639 (TX)

Record details

NPI number1609356864
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 17, 2018
Last updated in NPPESAugust 17, 2018
Mailing address5455 Knickerbocker Rd, San Angelo, TX 76904-7711

Other providers in San Angelo