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1124147954
MELODIE KAY WALLACE
SAN ANTONIO, TX
NPI
1124147954
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: TX 3539)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
-- MELODIE KAY WALLACE O.D.
17700 SAN PEDRO AVE SUITE 136
SAN ANTONIO, TX 78232-1404
Phone number: 210-494-3146
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Mailing Address
-- MELODIE KAY WALLACE O.D.
417 TEXAS PT
SAN ANTONIO, TX 78258-7737
Phone number: 210-481-0916
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