Kathy L. Wanderer, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC00565 Issued in TX

Practice address

1105 Ridge Rd # a
Rockwall, TX 75087-4217

Phone

(972) 772-3327

Fax

(972) 772-3327

NPI assigned

Dec 9, 2006

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

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699835967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 RIDGE RD # A",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874217",
            "telephone_number": "972-772-3327",
            "fax_number": "972-772-3327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 RIDGE RD # A",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874217",
            "telephone_number": "972-772-3327",
            "fax_number": "972-772-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDERER",
        "first_name": "KATHY",
        "middle_name": "L.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC00565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Wallace, PA-C
• Brittany Wallace, D.P.T.
• Jeffrey S Wallace, M.D.
• Mary Elise Wallace, MSRD/LD
• Gabriella Walton
• Daniel Enoch Wandrey, M.D.
• Erin Wandrey
• Alexus Wanton
• Dan G Warchol, DMD
• Jenaya Judonne Ward, MD

• Acupuncturist in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Acupuncturist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.