Active NPI
Terrielle Wallace
- Phlebotomy Technician
- Dallas, TX
National Provider Identifier
1447953021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- Practice address
- 3839 McKinney Ave Ste 155
Dallas, TX 75204-1488 - Phone
- (469) 227-0838
- NPI assigned
- Mar 23, 2023
- Last updated
- Mar 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | NU | Primary |
Addresses
Primary practice location
3839 McKinney Ave Ste 155
Dallas, TX 75204-1488
Mailing address
PMB 2668 3839 McKinney Avenue
Suite 155
Dallas, TX 75204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1447953021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 2668 3839 MCKINNEY AVENUE",
"address_2": "SUITE 155",
"city": "DALLAS",
"state": "TX",
"postal_code": "75204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3839 MCKINNEY AVE STE 155",
"city": "DALLAS",
"state": "TX",
"postal_code": "752041488",
"telephone_number": "469-227-0838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "TERRIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-23",
"last_updated": "2023-03-23",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.