Mary Meaghan Wallace, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP134629 Issued in TX

Practice address

1900 S Jackson Rd Ste 1
McAllen, TX 78503-1589

Phone

(956) 340-4222

Fax

(956) 307-3234

NPI assigned

Mar 19, 2018

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17384/brand/1/csg/1/fhir/r4
• Direct secure messaging: mwallace483792@prddirect.texaschildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gloria Ortiz, MD, P.a.

  dba RGV Endocrine Center

  • Endocrinology, Diabetes & Metabolism Physician
  • McAllen, TX
  • NPI 1669980058
  Medicare reassignment NPD
• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1760986558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST STE 2380",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302308",
            "telephone_number": "713-800-6212",
            "fax_number": "713-800-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S JACKSON RD STE 1",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785031589",
            "telephone_number": "956-340-4222",
            "fax_number": "956-307-3234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9301 Evening Primrose Path",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787503631",
            "country_code": "US",
            "telephone_number": "512-809-4121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MARY MEAGHAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "822658",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #09075)
• Walgreen Co (Walgreens #12859)
• Kenneth Leroy Walker Jr., PHARMD
• Raymond B Walker, CRNA
• Margaret Carling Wallace, OTD, OTR/L
• Ruby Rose Wallingsford, OTR
• Maria Pilar Perez Walterhouse
• Feng Wang, MD
• Juan Wang, AU.D.
• Carina Warner

• Family Nurse Practitioner in McAllen, TX
• Providers in McAllen, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.