Sandra Eugenia Wallace, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

016400 Issued in TX

Practice address

3627 Acornrun LN
Spring, TX 77389-4721

Phone

(281) 651-7716

NPI assigned

Sep 17, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Sandra Eugenia Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1518153295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 ACORNRUN LN",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773894721",
            "telephone_number": "281-651-7716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 ACORNRUN LN",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773894721",
            "telephone_number": "281-651-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SANDRA",
        "middle_name": "EUGENIA",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "016400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WALLACE",
            "middle_name": "EUGENIA",
            "credential": "ASSOCIATES DEGREE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Newsome Wall, NNP-BC, PNP-PC/AC
• Chressye Wallace
• Crosby W Wallace, O.D.
• Donna Lee Wallace, OT/L
• Nakeria N Wallace
• Nicole Jordan Walling, M.A, CCC-SLP
• Kennedy Walls
• Amy Susan Walsh, DPM
• Adelle Walston
• Tina Washington Walter

• Massage Therapist in Spring, TX
• Providers in Spring, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.