Renata Wallace

Primary specialty

Podiatric AssistantTaxonomy code 211D00000X

License

1451785 Issued in TX

Practice address

12820 Willow Centre Dr Ste a
Houston, TX 77066-1031

Phone

(281) 627-2863

NPI assigned

Sep 21, 2026

Last updated

Sep 21, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1831001031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12820 WILLOW CENTRE DR STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770661031",
            "telephone_number": "281-627-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12820 WILLOW CENTRE DR STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770661031",
            "telephone_number": "281-627-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "RENATA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "211D00000X",
            "taxonomy_group": "",
            "desc": "Assistant, Podiatric",
            "state": "TX",
            "license": "1451785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyesha Wallace
• Pamela Lindsey Wallace, PT, DPT
• Phyllis Marie Wallace, CRNA
• Rebecca Ann Wallace, MSW
• Rebekah Wallace, LCSW
• Shannon E Wallace
• Sharon Renee Wallace, MD
• Shawnee Wallace, DO
• Shernique Wallace, DDS
• Sowdhamini Shettigar Wallace, D.O.

• Podiatric Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Podiatric Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.