Individual
CLAIRE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-S
Contact information
Practice address
3600 N GARFIELD ST, MIDLAND, TX 79705-6329
(817) 688-0077
Mailing address
5213 BRYCE AVE, FORT WORTH, TX 76107-3613
(817) 688-0077
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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