DR. JESSE BRYAN WALLACE (NPI# 1871794495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871794495 |
| Entity Type | Individual |
| Full Name | DR. JESSE BRYAN WALLACE |
| Credential | D.C. |
| Practice Address |
7410 Blanco Rd Suite 400 San Antonio TX 78216-4363 |
| Practice Telephone | 8004046050 |
| Practice Fax Number | 2104777631 |
| Mailing Telephone | 8004046050 |
| Mailing Fax Number | 2104777631 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2008-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 10627 | TX | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568531416 | Jesse Wallace | Internal Medicine | 1138 Waterfall Ln, Lenoir, NC 28645-8943 | 2006-11-07 |
| 1174005995 | Jesse Wallace | Case Manager/Care Coordinator | 21000 Plummer St, Chatsworth, CA 91311-4903 | 2018-08-29 |
| Street Address |
7410 BLANCO RD SUITE 400 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78216-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932124187 | Doris Hudspeth Miller | Social Worker | 7410 Blanco Rd, Suite 100, San Antonio, TX 78216-4363 | 2006-07-12 |
| 1306259551 | Faye Makarsky | Massage Therapist | 7410 Blanco Rd, Ste 104, San Antonio, TX 78216-4363 | 2014-06-05 |
| 1942508429 | Jason Thomas Bassett | Chiropractor | 7410 Blanco Rd, San Antonio, TX 78216-4363 | 2011-03-07 |
| 1750688529 | David Christopher Bowden | Chiropractor | 7410 Blanco Rd, Suite 400, San Antonio, TX 78216-4363 | 2011-02-14 |
| 1740585140 | Sbc Ventures Corporation | Home Health | 7410 Blanco Rd, Suite 200, San Antonio, TX 78216-4363 | 2011-01-14 |
| 1699916494 | Sherry Rantz | Social Worker | 7410 Blanco Rd, Suite 100, San Antonio, TX 78216-4363 | 2009-03-09 |
| 1215187034 | Marcus Jay Johnson | Chiropractor | 7410 Blanco Rd, Suite 400, San Antonio, TX 78216-4363 | 2008-09-29 |
| 1437318920 | James Hugh Carter | Counselor | 7410 Blanco Rd, Suite 100, San Antonio, TX 78216-4363 | 2008-06-09 |
| 1902088594 | Airrosti Center, Inc. | Chiropractor | 7410 Blanco Rd, Suite 400, San Antonio, TX 78216-4363 | 2007-12-05 |
| 1639363104 | Kimblyn Lashun Gilyard | Registered Nurse | 7410 Blanco Rd, Ste 104, San Antonio, TX 78216-4363 | 2007-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376179820 | Damiana Lea Mcmahan | Speech-Language Pathologist | 12 Inter Park Blvd, #105, San Antonio, TX 78216 | 2020-03-17 |
| 1811530967 | Hacienda Hospice, Ltd | Hospice Care, Community Based | 101 W Silver Sands Dr, San Antonio, TX 78216 | 2019-10-22 |
| 1437792876 | Eddy Sidra | Optometrist | 7400 San Pedro Avenue, Suite 486, San Antonio, TX 78216 | 2019-10-17 |
| 1083256796 | Tiffany Michelle Goericke | Physical Therapist | 502 East Ramsey, San Antonio, TX 78216 | 2019-10-14 |
| 1780246942 | Esperanza Eating Disorders Center, Pllc | Clinic/Center | 403 E. Ramsey, Suite 204, San Antonio, TX 78216 | 2019-07-08 |
| 1568938314 | Lyric Lea Lewis | Licensed Vocational Nurse | 85 Ne Interstate 410 Loop #500, San Antonio, TX 78216 | 2018-10-19 |
| 1912488206 | Rebecca Anna Poppe | Licensed Vocational Nurse | 1514 Vista Del Norte, San Antonio, TX 78216 | 2018-08-24 |
| 1205338779 | Bailee Hannah Mokry | Behavioral Analyst | 11306 Sir Winston, San Antonio, TX 78216 | 2018-03-01 |
| 1487155677 | Ojer Corbie | Behavior Technician | 11310 Sir Winston At Bld D, San Antonio, TX 78216 | 2018-02-23 |
| 1366943631 | Briana Nicole Rodriguez | Behavior Technician | 14235 Blanco Road, San Antonio, TX 78216 | 2018-02-22 |
| Find all providers in zip 78216 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979276 | Shawn Brown | Chiropractor | 9910 Huebner Rd Ste 150, San Antonio, TX 78240-1399 | 2020-10-15 |
| 1073128682 | Ashley Escamilla Boerner & Associates LLC | Chiropractor | 12227 Huebner Rd Ste 102, San Antonio, TX 78230-1251 | 2020-09-10 |
| 1407466717 | Elida Ann Ramos | Chiropractor | 3011 S Flores St, San Antonio, TX 78204-2634 | 2020-08-03 |
| 1487289682 | Scott Castle | Chiropractor | 15739 San Pedro Ave, San Antonio, TX 78232-3726 | 2020-03-08 |
| 1912531328 | Alisa Sharma | Chiropractor | 7338 Louis Pasteur Dr Ste 101, San Antonio, TX 78229-4590 | 2020-02-24 |
| 1407499627 | Darian Moseley | Chiropractor | 8527 Village Dr Ste 101, San Antonio, TX 78217-5507 | 2019-10-21 |
| 1285276543 | Stone Oak Chiropractic | Chiropractor | 510 Med Ct Ste 207, San Antonio, TX 78258-3484 | 2019-10-08 |
| 1740746346 | Federal Medical Solutions | Chiropractor | 4423 Nw Loop 410 Ste 203, San Antonio, TX 78229-5186 | 2019-02-19 |
| 1023574803 | Cynthia Fierro-gomez | Chiropractor | 4804 Research Dr, San Antonio, TX 78240-5004 | 2019-02-15 |
| 1689140980 | Brianne Kerry Schroeder | Chiropractor | 9910 Huebner Rd Ste 150a, San Antonio, TX 78240-1399 | 2018-10-15 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78216 |
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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.