MARY MEAGHAN WALLACE (NPI# 1760986558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760986558 |
| Entity Type | Individual |
| Full Name | MARY MEAGHAN WALLACE |
| Practice Address |
9301 Evening Primrose Path Austin TX 78750-3631 |
| Mailing Address |
6624 Fannin St Ste 2380 Houston TX 77030-2308 |
| Practice Telephone | 5128094121 |
| Mailing Telephone | 7138006212 |
| Mailing Fax Number | 7138006241 |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 822658 | TX | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP134629 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9301 EVENING PRIMROSE PATH |
| City | AUSTIN |
| State | TX |
| Zip Code | 78750-3631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457843518 | Mydental At Anderson Mill Pllc | Dentist | 13450 N Highway 183 Ste 237a, Austin, TX 78750 | 2018-06-05 |
| 1003305442 | Brendan Michael Harvey | Counselor | 12343 Hymeadow Dr Ste 2h, Austin, TX 78750 | 2018-05-01 |
| 1033621339 | Dr. Grant Glauser Dds Pllc | Clinic/Center | 12401 Hymeadow Dr, Bldg 5, Austin, TX 78750 | 2017-10-27 |
| 1649798166 | Poest Dental Pllc | Dentist | 10601 Pecan Park Blvd., Suite 101, Austin, TX 78750 | 2017-09-05 |
| 1255858031 | Pearl Priscilla Martinez | Marriage & Family Therapist | 13359 N Highway 183 Ste 406-611, Austin, TX 78750 | 2017-08-23 |
| 1295262814 | Atlas Orthopedic Products LLC | Prosthetic/Orthotic Supplier | 13785 Research Blvd Ste 125, Austin, TX 78750 | 2017-05-12 |
| 1790138691 | Dr. Marc Amsili | Dentist | 12335 Hyemeadow Drive, Ste 250, Austin, TX 78750 | 2016-07-15 |
| 1972991743 | Krista Yeh | Nurse Practitioner | 13617 Caldwell Drive, Austin, TX 78750 | 2015-01-02 |
| 1275960460 | Kristyn Magoon | Physician Assistant | 13617 Caldwell Dr., Suite 100, Austin, TX 78750 | 2013-10-02 |
| 1023454386 | Fuad Makkouk | Ophthalmology | 9707 Anderson Mill Rd Ste 220, Austin, TX 78750 | 2013-05-14 |
| Find all providers in zip 78750 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616992 | Nancy Toll | Nurse Practitioner | 8600 N Fm 620 Rd Apt 936, Austin, TX 78726-3535 | 2020-10-13 |
| 1003413055 | Anthony Delovino Lista | Nurse Practitioner | 311 Bowie St Apt 1215, Austin, TX 78703-5296 | 2020-10-02 |
| 1366049553 | Lauren Nicole Crider | Nurse Practitioner | 3601 S Congress Ave Ste D100, Austin, TX 78704-7205 | 2020-10-01 |
| 1366059784 | Teresa Marie Reed | Nurse Practitioner | 3921 Steck Ave Ste A120, Austin, TX 78759-8669 | 2020-09-29 |
| 1144836289 | Amy Silva | Nurse Practitioner | 1824 Rainy Meadows Dr, Austin, TX 78758-3518 | 2020-09-22 |
| 1326652470 | Carolyn Lee Stanford | Nurse Practitioner | 14902 Crosscreek, Austin, TX 78737-8904 | 2020-09-06 |
| 1457965899 | Lorie Kmetz | Nurse Practitioner | 1907 Alguno Rd, Austin, TX 78757-3220 | 2020-09-02 |
| 1184238735 | Amanda Kanski | Nurse Practitioner | 9525 N Capital of Texas Hwy Unit 416, Austin, TX 78759-7294 | 2020-09-01 |
| 1487265013 | Lisa Karen Brogan | Nurse Practitioner | 1805 Forest Hill Dr, Austin, TX 78745-1720 | 2020-08-17 |
| 1992316327 | Mona Saberi | Nurse Practitioner | 15024 Calaveras Dr, Austin, TX 78717-4577 | 2020-08-10 |
| Find all providers in AUSTIN | ||||
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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.