Wallace, Annaliesa

Wallace, Annaliesa is an individual health care provider with primary practice located at 1331 Bandera Hwy Ste 2, Kerrville TX 78028-9515. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Wallace, Annaliesa can be contacted via phone (830) 895-7755.

Contact Information

Primary practice address
1331 Bandera Hwy Ste 2 Kerrville TX 78028-9515
Phone: (830) 895-7755
Fax: (830) 895-7757
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA09066 Texas

Profile Details

NPI number 1255744363
LBN Legal business name Wallace, Annaliesa
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2014
Last updated Mar 10th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255744363 NPPES
Texas Other 8301NJ BCBS OF TEXAS

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