STACY WALLACE NP
NPI 1205843422
Nurse Practitioner - Pediatrics in San Antonio, TX

Q: What is Stacy Wallace's NPI number?

The NPI number for Stacy Wallace is 1205843422. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is Stacy Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Wallace was last updated on January 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 01, 2006

1702 N ALAMO ST, SUITE 220, SAN ANTONIO, TX 78215(210) 224-1823(210) 224-7011 Get Directions Write a Review

NPPES record last updated: January 27, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Stacy Wallace Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY WALLACE NP (NPI 1205843422) is an individual pediatrics provider in San Antonio, Texas, licensed in Texas (624860) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1205843422

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameSTACY WALLACECredential: NP

Location Address1702 N ALAMO ST, SUITE 220San Antonio, TX 78215-1201

Mailing Address1702 N Alamo St, Suite 220San Antonio, TX 78215-1201 · (210) 224-1823 · Fax (210) 224-7011

Phone(210) 224-1823

Fax(210) 224-7011

Sole ProprietorNo

Enumeration DateAugust 1, 2006

Last NPPES UpdateJanuary 27, 2010

✔ NPI 1205843422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in TX · 624860

1702 N ALAMO ST, San Antonio, TX 78215

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Other Identifiers 3

Other67466TX · Cidc

Medicaid181428701TX

Medicare PIN8G3848TX

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JUDITH ANN WALKER EDD, RN, CPNP

Nurse Practitioner (Pediatrics)

1702 N ALAMO ST, # 220
SAN ANTONIO, TX 78215

Bexar County (210) 224-1823

MS. BERTHA E. ARENAS FNP

Nurse Practitioner (Family)

1702 N ALAMO ST
SAN ANTONIO, TX 78215

Bexar County (210) 224-1823

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Wallace's NPI number?

The NPI number for Stacy Wallace is 1205843422. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Stacy Wallace located?

Stacy Wallace practices at 1702 N Alamo St Suite 220, San Antonio, TX 78215. The listed phone number is (210) 224-1823.

What is Stacy Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Stacy Wallace was last updated on January 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.