Individual
ANNALIESA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1331 BANDERA HWY, STE 2, KERRVILLE, TX 78028-9515
(830) 895-7755
(830) 895-7757
Mailing address
708 HILL COUNTRY DR, STE 300A, KERRVILLE, TX 78028-6079
(830) 895-7755
(830) 895-7757
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA09066
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8301NJ
BCBS OF TEXAS
TX
Enumeration date
06/05/2014
Last updated
03/10/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us