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

Mr. Terrell Richard Wallace Jr., PAC

Individual provider Medical Physician Assistant · NPI 1356399828

Mr. Terrell Richard Wallace Jr., PAC is a Medical Physician Assistant in Warner Robins, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

136 S Houston Lake Rd
Warner Robins, GA 31088
Phone: (478) 953-1020
Fax: (478) 953-5406
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 002665 (GA)

Record details

NPI number1356399828
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedMay 5, 2006
Last updated in NPPESSeptember 18, 2012

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