person
Annaliesa Wallace, PA
Medical Physician Assistant in Kerrville, Texas
NPI 1255744363

Annaliesa Wallace is a Medical Physician Assistant based in Kerrville, TX and is specialized in Medical. Annaliesa Wallace practices in Kerrville, TX and has the professional credentials of PA. The NPI Number for Annaliesa Wallace is 1255744363 and holds a License No. PA09066 (Texas).

The current practice location address for Annaliesa Wallace is 1331 Bandera Hwy, Kerrville, TX and can be reached out via phone at 830-895-7755 and via fax at 830-895-7757.

Location: 1331 Bandera Hwy, Kerrville, TX, 78028-6079
person
Provider Profile Details
NPI Number
1255744363
Provider Name
Annaliesa Wallace
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
1331 Bandera Hwy, Kerrville, TX, 78028-6079
Phone Number
830-895-7755
Fax Number
830-895-7757
Provider Enumeration Date
06/05/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8301NJ 01 TX BCBS OF TEXAS
institution
Provider Business Practice Location Address Details
Address
1331 Bandera Hwy
City
State
Zip
78028-9515
Phone Number
830-895-7755
Fax Number
830-895-7757
person
Provider Business Mailing Address Details
Address
1331 Bandera Hwy
City
State
Zip
78028-9515
Phone Number
830-895-7755
Fax Number
830-895-7757
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA09066 (Texas)
Definition
Definition to come...
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