Individual
MISS KIMBERLY LOUISE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2040 BABCOCK RD STE 304, SAN ANTONIO, TX 78229-4428
(210) 731-9570
(210) 731-9575
Mailing address
2040 BABCOCK RD STE 304, SAN ANTONIO, TX 78229-4428
(210) 731-9570
(210) 731-9575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
256026
TX
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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