Individual
JENNA L WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6440
(979) 207-4000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
T5059
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2019
Last updated
07/14/2022
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