Deanna Elena Wallace, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

7616 Branford PL Ste 320
Sugar Land, TX 77479-3794

Phone

(819) 801-7422

NPI assigned

Feb 11, 2009

Last updated

Jul 28, 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 1

Addresses

Electronic endpoints 1

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

Physician Assistant

Interoperability endpoints

• Direct secure messaging: elena.wallacepac.p1@direct.fbrtx.nextgenshare.com
• Direct secure messaging: fbtrx@direct.fbrtx.nextgenshare.com

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.

• Fort Bend Rheumatology Associates PLLC

  • Specialist
  • Sugar Land, TX
  • NPI 1770516551
  Medicare reassignment

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1861631004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12553 GULF FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770344509",
            "telephone_number": "281-481-8557",
            "fax_number": "281-481-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7616 BRANFORD PL STE 320",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793794",
            "telephone_number": "819-801-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DEANNA",
        "middle_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbtrx@direct.fbrtx.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "fbratx",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7616 Branford Pl Ste 320",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774793794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Walgreen Co (Walgreens #06783)
• Walgreen Co (Walgreens #1157)
• Madelaine Nicole Walker, DO
• Pamela C Walker, OTR
• Taloya Walker, CCC-SLP
• Latoya Wallace
• Luciana Wallenstein
• Alicia Regina Walls, M.D.
• Wiley Walls, OD
• Brian Walter, D.O.

• Medical Physician Assistant in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.