STACY WALLACE (NPI# 1205843422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205843422 |
Entity Type | Individual |
Full Name | STACY WALLACE |
Credential | NP |
Practice Address |
1702 N Alamo St Suite 220 San Antonio TX 78215-1201 |
Practice Telephone | 2102241823 |
Practice Fax Number | 2102247011 |
Mailing Telephone | 2102241823 |
Mailing Fax Number | 2102247011 |
Enumeration Date | 2006-08-01 |
Last Update Date | 2010-01-27 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
624860 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | CIDC | 67466 | 01 |
TX | 181428701 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386264109 | Stacy Wallace | Driver | 324 Kenilworth Ave, Toledo, OH 43610-1456 | 2020-04-22 |
1588131866 | Stacy Ann Wallace | Naturopath | 3976 East Harbor Road, Langley, WA 98260 | 2018-10-25 |
1487896668 | Stacy L Wallace | Dietitian, Registered | 20330 Huebner Rd, Suite 104, San Antonio, TX 78258-3508 | 2009-04-02 |
1952876641 | Stacy Rose Wallace | Chore Provider | 6725 S Eastern Ave, Las Vegas, NV 89119-3948 | 2018-10-09 |
1003249848 | Stacy Lea Wallace | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2013-08-15 |
Street Address |
1702 N ALAMO ST SUITE 220 |
City | SAN ANTONIO |
State | TX |
Zip Code | 78215-1201 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598768541 | Bertha E. Arenas | Nurse Practitioner | 1702 N Alamo St, San Antonio, TX 78215-1201 | 2005-05-23 |
1336142405 | Judith Ann Walker | Nurse Practitioner | 1702 N Alamo St, # 220, San Antonio, TX 78215-1201 | 2005-05-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710487780 | Webster Street Dental Pllc | Clinic/Center | 311 E Jones Ave, San Antonio, TX 78215 | 2018-02-16 |
1699215293 | Monique Gonzalez | Nurse Practitioner | 311 Camden St., Suite 510, San Antonio, TX 78215 | 2017-03-01 |
1477958015 | Rachel Lynn Stein | Nurse Practitioner | 311 Camden St Ste 501, San Antonio, TX 78215 | 2014-10-24 |
1962837005 | Jessica Maria Leighton | Nurse Practitioner | 926 Brooklyn Ave Ste 100, San Antonio, TX 78215 | 2013-09-09 |
1891037123 | Michael Aguilar Davila | Clinic/Center | 303 E Quincy Ste 104, Physician Health Services, San Antonio, TX 78215 | 2013-03-25 |
1265669584 | Colin Townes Son | Neurological Surgery | 123 Roy Smith St Apt 1211, San Antonio, TX 78215 | 2009-06-12 |
1306082292 | Dario Fernandez | Physical Therapist | 302 E Josephine St Ste 1101, San Antonio, TX 78215 | 2008-12-23 |
1992966584 | Vcphcs Vii, LLC | Clinic/Center | 519 E. Quincy, San Antonio, TX 78215 | 2008-06-17 |
1871686360 | Inocencio A. Davila, M.d.,p.a. | Anesthesiology | 621 N. Alamo, San Antonio, TX 78215 | 2006-10-02 |
1730282708 | Elizabeth S Brickman | Pediatrics | 311 Camden, Suite 214, San Antonio, TX 78215 | 2006-09-06 |
Find all providers in zip 78215 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124629308 | Megan Marie Burson | Nurse Practitioner | 9002 Culebra Rd Unit 100, San Antonio, TX 78251-2873 | 2020-11-04 |
1346849817 | Abbie Leigh Collins | Nurse Practitioner | 4499 Medical Dr Ste 289, San Antonio, TX 78229-3712 | 2020-10-25 |
1982238317 | Belinda Dixon | Nurse Practitioner | 3422 Krie Highlands, San Antonio, TX 78245-1678 | 2020-02-25 |
1316580327 | Traci Dee Ulibarri | Nurse Practitioner | 431 Centro Hermosa, San Antonio, TX 78245-1298 | 2019-10-22 |
1912471012 | Sarah Alba | Nurse Practitioner | 9002 Culebra Rd # 100, San Antonio, TX 78251-2873 | 2019-01-11 |
1285105536 | Lizbeth Barba | Nurse Practitioner | 20642 Stone Oak Pkwy Ste 105, San Antonio, TX 78258-7363 | 2018-12-16 |
1427526839 | Christina Ferris | Nurse Practitioner | 7323 Marbach Rd Ste 107, San Antonio, TX 78227-1907 | 2018-11-05 |
1902309511 | Lauren R Carter Rohrer | Nurse Practitioner | 4522 Fredericksburg Rd Ste A11, San Antonio, TX 78201-6509 | 2018-03-10 |
1619426053 | Erica Annotti | Nurse Practitioner | 903 W Martin St Fl 6, San Antonio, TX 78207 | 2016-09-27 |
1669837720 | Rebekah Randall | Nurse Practitioner | 21195 W Ih 10 Ste 2101, San Antonio, TX 78257-1675 | 2015-12-16 |
Find all providers in SAN ANTONIO |
City | SAN ANTONIO |
Zip Code | 78215 |
Please comment or provide details below to improve the information on STACY WALLACE.
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.