STACY WALLACE

SAN ANTONIO, TX
NPI1205843422
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: TX  624860)
Enumeration Date2006-08-01
Last Update Date2010-01-27
Business Address
-- STACY WALLACE NP
1702 N ALAMO ST SUITE 220
SAN ANTONIO, TX 78215-1201
Phone number: 210-224-1823
Mailing Address
-- STACY WALLACE NP
1702 N ALAMO ST SUITE 220
SAN ANTONIO, TX 78215-1201
Phone number: 210-224-1823
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