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MARIA GUADALUPE WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9939 STATE HIGHWAY 151, SAN ANTONIO, TX 78251-1900
(210) 617-5300
Mailing address
9939 STATE HIGHWAY 151, SAN ANTONIO, TX 78251-1900

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1097490
TX

Other

Enumeration date
01/18/2023
Last updated
01/18/2023
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