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

Mr. Derek James Wallace

Individual provider Critical Care Medicine Registered Nurse · NPI 1174350276

Mr. Derek James Wallace is a Critical Care Medicine Registered Nurse in San Antonio, Texas. Licensed in Texas. Registered with an NPI since 2024.

Licensed in
TX
In the registry since
2024

Practice location Address checks out

7400 Merton Minter St
San Antonio, TX 78229-4404
Phone: (210) 617-5300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Medicine Registered Nurse (primary) Taxonomy 163WC0200X · Licence 947136 (TX)

Record details

NPI number1174350276
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 14, 2024
Last updated in NPPESSeptember 14, 2024
Certification dateSeptember 14, 2024
Mailing address7400 Merton Minter St, San Antonio, TX 78229-4404

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