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1487896668
STACY L WALLACE
SAN ANTONIO, TX
NPI
1487896668
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133VN1006X Dietitian, Registered, Nutrition, Metabolic
(Licence: TX 855077)
Enumeration Date
2009-04-02
Last Update Date
2009-04-02
Business Address
-- STACY L WALLACE RD
20330 HUEBNER RD SUITE 104
SAN ANTONIO, TX 78258-3508
Phone number: 832-237-3500
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Mailing Address
-- STACY L WALLACE RD
11321 FALLBROOK DR
HOUSTON, TX 77065-4232
Phone number: 832-237-3500
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