STACY WALLACE


Address: 1702 N Alamo St, Suite 220, San Antonio, TX 78215-1201
Phone: 2102241823

STACY WALLACE (NPI# 1205843422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
624860 TX Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX CIDC 67466 01
TX 181428701 05

Other Providers STACY WALLACE

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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

Office Location

Street Address 1702 N ALAMO ST
SUITE 220
City SAN ANTONIO
State TX
Zip Code 78215-1201

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City SAN ANTONIO
Zip Code 78215

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Dataset Information

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.

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