Individual
SALLY JO WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
201 S LAKELINE BLVD, SUITE 405, CEDAR PARK, TX 78613-2718
(512) 381-4272
(512) 381-4275
Mailing address
201 S LAKELINE BLVD, SUITE 405, CEDAR PARK, TX 78613-2718
(512) 381-4272
(512) 381-4275
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00311
TX
Other
Enumeration date
11/03/2006
Last updated
08/27/2014
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