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Shannon Wallace
NPI 1649053489 · on the registry since 2023 · sole proprietor
Practice
- Address
- 7490 Brompton St Apt 371
Houston, TX 77025 - Phone
- (727) 810-5166
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 374J00000X
374J00000X
- Also registered as
- 171400000X
251K00000X - Sex
- Female
- Record last updated
- 2023-08-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas