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1164122149
CARLA DENNISE WALLACE
PEARLAND, TX
NPI
1164122149
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: TX 1095104)
Enumeration Date
2023-03-07
Last Update Date
2024-06-20
Business Address
CARLA DENNISE WALLACE A-GNP-C
2421 COPPER SKY DR
PEARLAND, TX 77584-3782
Phone number: 409-350-0016
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Mailing Address
CARLA DENNISE WALLACE A-GNP-C
2421 COPPER SKY DR
PEARLAND, TX 77584-3782
Phone number: 409-350-0016
Copy
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