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Stacy Wallace, NP
Pediatric Nurse Practitioner in San Antonio, Texas
NPI 1205843422

Stacy Wallace is a Pediatric Nurse Practitioner based in San Antonio, TX and is specialized in Pediatrics. Stacy Wallace practices in San Antonio, TX and has the professional credentials of NP. The NPI Number for Stacy Wallace is 1205843422 and holds a License No. 624860 (Texas).

The current practice location address for Stacy Wallace is 1702 N Alamo St, San Antonio, TX and can be reached out via phone at 210-224-1823 and via fax at 210-224-7011. You can also correspond with Stacy Wallace through the mailing address at 1702 N ALAMO ST, SAN ANTONIO, TX - 78215-1201 (mailing address contact number: 210-224-1823).

Location: 1702 N Alamo St, San Antonio, TX, 78215-1201
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Provider Profile Details
NPI Number
1205843422
Provider Name
Stacy Wallace
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
1702 N Alamo St, San Antonio, TX, 78215-1201
Phone Number
210-224-1823
Fax Number
210-224-7011
Provider Enumeration Date
08/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
181428701 05 TX
67466 01 TX CIDC
institution
Provider Business Practice Location Address Details
Address
1702 N Alamo St
City
State
Zip
78215-1201
Phone Number
210-224-1823
Fax Number
210-224-7011
person
Provider Business Mailing Address Details
Address
1702 N Alamo St
City
State
Zip
78215-1201
Phone Number
210-224-1823
Fax Number
210-224-7011
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
624860 (Texas)
Definition
Definition to come...
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