Stacy L Wallace RD

NPI 1487896668 - Dietitian, Registered - 133VN1006X

NPI Details
NPI 1487896668
Gender Female
Enumeration Date 04/02/2009
Last Updated 04/02/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
20330 HUEBNER RD
SUITE 104
SAN ANTONIO TX, 78258-3508, US
Phone (832) 237-3500
Fax (832) 237-0200
Business Location
11321 FALLBROOK DR
HOUSTON TX, 77065-4232, US
Phone (832) 237-3500
Fax (832) 237-0200
Toxanomy
Taxonomy Code 133VN1006X
License State Texas
License Number 855077
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According to our database, Stacy L Wallace RD NPI is 1487896668, taxonomy code is 133VN1006X and license number is 855077, license state is located at Texas. Stacy L Wallace RD physically located at 20330 Huebner Rd, San Antonio TX, 78258-3508. NPI Number Stacy L Wallace RD has the Individual type.

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1487896668 NPI number is provided on an as is basis without warranty of any kind. 1487896668 is maintained by the National Plan & Provider Enumeration System. The contents of Stacy L Wallace RD are for informational purposes only.