Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164422481 Individual Practitioner Male Practitioner

Dr. Charles Alan Wallace , MD

Surgery - Plastic and Reconstructive Surgery • Dallas, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Charles Wallace, MD is a certified Surgery - Plastic and Reconstructive Surgery practicing in Dallas, TX. With approximately 44 years of clinical experience since graduating from University Of Texas Southwestern Medical School At Dallas in 1982, Dr. Wallace delivers high-quality medical care to the local community at 17110 DALLAS PKWY.

Dr. Wallace accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

17110 Dallas Pkwy
Suite 100

Dallas, TX 752481167

Telephone 9723807090
Fax 9723807016
Associated Practice Facility / Clinic
🏢 Bent Tree Surgery Center Facility NPI 1740223429

Medicare Profile & Education

Medical School

University Of Texas Southwestern Medical School At Dallas

Graduation Year

1982

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Dallas, TX

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
44 Yrs +18.6 yrs vs City Avg
City Avg: 25.4 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
49 Specialists

Practicing in Dallas, TX (402 Statewide)

Telehealth Adoption Rate
6.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wallace (44 Years) 44 Yrs
Dallas Specialty Average (25.4 Years) 25.4 Yrs

Medical Specialties & State Licenses

Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License TX G3885

A surgeon who specializes in plastic and reconstructive surgery.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Jordyn Ghanem , FNP-C

Nurse Practitioner - Family

NPI 1285439760

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 14, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location July 14, 2010

Registered at 17110 DALLAS PKWY, SUITE 100, DALLAS, TX 752481167 (Tel: 9723807090)

📍
Updated Business Mailing Address July 14, 2010

Registered at 17110 DALLAS PKWY, SUITE 100, DALLAS, TX 752481167 (Tel: 9723807090)

👤
Provider Name / Credentials Updated July 14, 2010

Recorded as CHARLES WALLACE, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2010

Surgery (License #G3885 in TX)

🟢
Initial NPI Registration & Enumeration July 28, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164422481
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2005
Last Update: July 14, 2010
Sole Proprietor: Yes

Mailing Address

17110 Dallas Pkwy, Suite 100

Dallas, TX 752481167

Phone: 9723807090

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.