Wallace, Lourdes Ivette

Wallace, Lourdes Ivette is an individual health care provider with primary practice located at 113 Pleasant Valley Dr Ste 210 , Boerne TX 78006-5683. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Wallace, Lourdes Ivette can be contacted via phone (830) 267-4575.

Contact Information

Primary practice address
113 Pleasant Valley Dr Ste 210 Boerne TX 78006-5683
Phone: (830) 267-4575
Fax: (830) 267-4575
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN860816 Texas
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 11670071-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP126548 Texas
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 11670071-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP126548 Texas

Profile Details

NPI number 1659773869
LBN Legal business name Wallace, Lourdes Ivette
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 18th, 2014
Last updated Sep 3rd, 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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