WALLACE D WOMACK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1154691327

WALLACE D WOMACK (CRNA) is a healthcare provider. based in Nacogdoches, Texas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 688255 (TX). The NPI Number for WALLACE D WOMACK (CRNA) is 1154691327

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
WALLACE D WOMACK (CRNA)
NPI
1154691327
Phone
(936) 568-8525
Address
1204 N MOUND ST
Enumeration Date
5 January 2012
Last Update Date
13 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8178374600
Graduation Year
2011 (15 years ago)
PAC ID
1850550070
Group Practice PAC ID
3870879828
Professional Enrollment ID
I20120307000836
Address ID
TX762625302TR2850X114X413
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

5,279 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TX

Provider Addresses for WALLACE D WOMACK (CRNA)

  • 1204 N MOUND ST

    NACOGDOCHES, TX 759614027

    Phone: (936) 568-8525

    Type: Location

  • 2615 COUNTY ROAD 536

    NACOGDOCHES, TX 759613931

    Phone: (903) 312-8658

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120307000836ICertified Registered Nurse Anesthetist (Crna)TXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery5754$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1313$0
00811Anesthesia for other procedure on large bowel using an endoscope1212$0
View full utilization report →

Insurance plans in this area (ZIP 75961)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870879828View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YTX
-TX
Anesthesiology, Interventional Pain ManagementTX
A N E S T H E S I O L O G YNY
A N E S T H E S I O L O G YTX
Pain Management, Anesthesiology, Interventional Pain ManagementTX
A N E S T H E S I O L O G YTX
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YCA
Certified Registered Nurse Anesthetist (Crna)TX

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Frequently asked questions

How do I look up WALLACE D WOMACK (CRNA) by NPI?
Use NPI 1154691327 when you need to reference WALLACE D WOMACK (CRNA) in forms, claims, or directories.
Is WALLACE D WOMACK (CRNA) currently active in the NPI registry?
CMS-published data lists WALLACE D WOMACK (CRNA) as an active registrant.
Can you summarize WALLACE D WOMACK (CRNA)'s specialty in plain language?
Clinically, the directory lists WALLACE D WOMACK (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location shows for WALLACE D WOMACK (CRNA)?
We surface Nacogdoches, Texas for WALLACE D WOMACK (CRNA) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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