# CARLA WALLACE NURSE PRACTITIONER, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972322212
- **Authorized official:** CARLA WALLACE GNP (OWNER)
- **Authorized official phone:** (409) 350-0016

## Contact information

- **Practice address:** 2421 COPPER SKY DR, PEARLAND, TX 77584-3782
- **Practice address phone:** (409) 350-0016
- **Practice address fax:** (877) 673-2947
- **Mailing address:** 2421 COPPER SKY DR, PEARLAND, TX 77584-3782
- **Mailing address phone:** (409) 350-0016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2024
- **Last updated:** 02/20/2026