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Individual

CARLA DENNISE WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A-GNP-C

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1095104
TX

Other

Enumeration date
03/07/2023
Last updated
02/20/2026
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