Individual
LAUREN MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5400 E TEXAS ST, BOSSIER CITY, LA 71111-6906
(318) 675-1313
(888) 965-0619
Mailing address
441 POINT PLACE RD, DOWNSVILLE, LA 71234-5807
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/15/2026
Last updated
03/13/2026
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