MRS. BRENDA WALLACE (NPI# 1104130426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104130426 |
| Entity Type | Individual |
| Full Name | MRS. BRENDA WALLACE |
| Credential | PA-C |
| Practice Address |
3142 Horizon Rd Ste 209 Rockwall TX 75032-7802 |
| Practice Telephone | 9727712018 |
| Practice Fax Number | 9727724654 |
| Mailing Telephone | 9727712018 |
| Mailing Fax Number | 9727724654 |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2019-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA06792 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912211681 | Brenda Renee Wallace | Clinical Nurse Specialist | 1406 Rowantree Dr, Dover, FL 33527-4937 | 2010-08-04 |
| 1275703647 | Brenda Janice Wallace | Registered Nurse | 3107 Eastwick Dr, Cleveland Heights, OH 44118-1222 | 2008-03-03 |
| 1457482903 | Brenda Wallace | Speech-Language Pathologist | 712 Girard Blvd Ne, Jefferson Ms, Albuquerque, NM 87106-2714 | 2007-03-08 |
| Street Address |
3142 HORIZON RD STE 209 |
| City | ROCKWALL |
| State | TX |
| Zip Code | 75032-7802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699192674 | Shawn Holloway | Nurse Practitioner | 3142 Horizon Rd Ste 209, Rockwall, TX 75032-7802 | 2014-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780291229 | Alexandra Messer | Nurse Practitioner | 6435 S Farm To Market, #201, Heath, TX 75032 | 2020-09-29 |
| 1720649338 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 551 Laurence Dr, Health, TX 75032 | 2019-06-25 |
| 1346725579 | Arc 32 Family Dentistry | Dentist | 4 Horizon Court Suite 400, Heath, TX 75032 | 2018-10-03 |
| 1275039257 | Karina Bartz Dds Pllc | Dentist | 110 Smirl Drive, Suite 101, Heath, TX 75032 | 2018-03-30 |
| 1861994337 | Lumin Health Physician Group, Pa | Pain Medicine | 4450 Tubbs Road, Rockwall, TX 75032 | 2018-03-01 |
| 1871002816 | Aurentz Family Dental | Clinic/Center | 3140 Horizon Rd Suite 103, Rockwall, TX 75032 | 2017-09-21 |
| 1902200199 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 4282 Ridge Rd, Heath, TX 75032 | 2014-10-16 |
| 1962744714 | Yongrui Luan | Pediatrics | 1005 W Ralph Hall Pkwy Ste 135, Rockwall, TX 75032 | 2013-03-20 |
| 1558608679 | Nikalaus Loyd Laymon | Massage Therapist | 860 Ralph Hall Pkwy, #46, Rockwall, TX 75032 | 2013-01-09 |
| 1932444999 | Chiro One Wellness Center of Rockwall Pllc | Chiropractor | 2881 Market Center Drive, Rockwall, TX 75032 | 2012-12-03 |
| Find all providers in zip 75032 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093281180 | Tammy Nguyen | Physician Assistant | 3164 Horizon Rd # 100, Rockwall, TX 75032-7805 | 2018-10-16 |
| 1780196717 | Arze Medical Pllc | Physician Assistant | 3864 Juniper Hills Dr, Rockwall, TX 75032-9233 | 2017-10-31 |
| 1346670056 | Mark Hill Hokett | Physician Assistant | 3090 N Goliad St Ste 110, Rockwall, TX 75087 | 2013-11-15 |
| 1598026940 | Karen Melinda Bartosh | Physician Assistant | 1118 Newkirk Ct, Rockwall, TX 75032-7474 | 2012-06-01 |
| 1619280948 | Christina L Roberts | Physician Assistant | 1005 W Ralph Hall Pkwy Ste 201, Rockwall, TX 75032-6662 | 2010-07-15 |
| 1043359920 | Randall Farrer | Physician Assistant | 3142 Horizon Rd Ste 100, Rockwall, TX 75032-7815 | 2007-02-06 |
| 1760544811 | Richard Alfred Labelle | Physician Assistant | 3912 Whitman Dr, Rockwall, TX 75087-6592 | 2006-12-15 |
| 1851313340 | Hayward Johnson Sr. | Physician Assistant | 810 E Ralph Hall Pkwy, Suite 100, Rockwall, TX 75032-6878 | 2006-07-24 |
| 1114950359 | Loretta Fern Docekal | Physician Assistant | 3090 N. Goliad Suite 110, Rockwall, TX 75087 | 2006-07-09 |
| 1346713930 | Amy Phillips Gonzalez | Physician Assistant | 1301 Summer Lee Dr, Rockwall, TX 75032-5452 | 2019-01-07 |
| Find all providers in ROCKWALL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.