Individual
JACOB COLE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W 4TH ST, ODESSA, TX 79761-5059
(432) 640-4000
Mailing address
500 W 4TH ST, ODESSA, TX 79761-5059
(432) 631-2406
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
1160284
TX
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up