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WALLACE, JASON RENE
Practice Address: COMMUNITY RADIOLOGY ASSOCIATES
7418 JOHN SMITH DRIVE
SUITE 218
SAN ANTONIO TX 78229-6020

Address last updated on 9/14/2012
Phone #: (210) 614-0959
Fax #:
County: NOT OKLAHOMA
License: 28371
Dated: 10/10/2011
Expires: 10/1/2013
License Type: Medical Doctor
Specialty: Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduated: 5 / 2001
CME Year: 2014
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF RADIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
COMMUNITY RADIOLOGY ASSOCIATES
7418 JOHN SMITH DRIVE
SUITE 218
SAN ANTONIO TX 78229-6020

Phone #: (210) 614-0959
Fax #:

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