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1003541095
IMELDA V WALLACE
EL PASO, TX
NPI
1003541095
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 2022000137)
Enumeration Date
2022-07-22
Last Update Date
2022-07-22
Business Address
IMELDA V WALLACE FNP-BC
11860 VISTA DEL SOL DR STE 150
EL PASO, TX 79936-6128
Phone number: 915-808-4000
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Mailing Address
IMELDA V WALLACE FNP-BC
11860 VISTA DEL SOL DR STE 150
EL PASO, TX 79936-6128
Phone number: 915-808-4000
Copy
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