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Export Provider Record NPI 1174802631
Amwallace, Llc
Organization Subpart: NO
Active
NPI Number1174802631
NPI TypeNPI-2 Organization
SpecialtyOptometrist
Provider Details
NPI1174802631
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2011-08-15
Last Updated2020-03-25
Authorized OfficialAugust Wallace
Doctor/Owner
Phone: 9036632020
Mailing Address3032 N Eastman Rd Ste 100
Longview, TX 75605-5024
United States
Phone: (903) 663-2020 | Fax: (903) 663-2353
📍 View Map
Primary Practice Address3032 N Eastman Rd Ste 100
Longview, TX 75605-5024
United States
Phone: (903) 663-2020 | Fax: (903) 663-2353
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes152W00000X – OptometristTXT07660
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About NPI 1174802631

Amwallace, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1174802631. The primary specialty listed is Optometrist. The organization is located in Longview, TX. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-08-15. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1174802631?

NPI 1174802631 belongs to Amwallace, Llc, a Optometrist in Longview, TX. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1174802631 active?

The current status of NPI 1174802631 in the NPPES registry is Active. The record was last updated on 2020-03-25.

What specialty is NPI 1174802631?

NPI 1174802631 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1174802631?

You can verify NPI 1174802631 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1174802631?

The primary practice address on file for NPI 1174802631 is 3032 N Eastman Rd Ste 100, Longview, TX 75605-5024. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1174802631 issued?

NPI 1174802631 was first issued (enumerated) on 2011-08-15. The NPPES record was last updated on 2020-03-25.

Practice Location Map

Amwallace, Llc is located at 3032 N Eastman Rd Ste 100, Longview, TX. Use the map below to find directions or verify the practice location.

📍 3032 N Eastman Rd Ste 100, Longview, TX 75605-5024  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Amwallace, Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1174802631. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
OptometristT07660TX
Data Verified from CMS NPPES Last synced: 2026-07-10 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162