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

Reginald Wallace, PA-C

Individual provider Medical Physician Assistant · NPI 1265779441

Reginald Wallace, PA-C is a Medical Physician Assistant in Stafford, Texas. Licensed in Texas. Registered with an NPI since 2013.

Licensed in
TX
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

12603 SW Fwy Ste 335
Stafford, TX 77477-3820
Phone: (713) 398-7337
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA02096 (TX)

Record details

NPI number1265779441
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 8, 2013
Last updated in NPPESJanuary 8, 2013
Mailing address3231 Truesdale Dr, Missouri City, TX 77459-4947

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