Leticia Wallace, R.D.,L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT80777 Issued in TX

Practice address

211 Comal St
Austin, TX 78702-4326

Phone

(512) 978-8130

NPI assigned

Nov 12, 2009

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

Other names 1

• Leticia W McLeod Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Travis County Healthcare District

  dba Central Health

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1972271831
  Medicare reassignment NPD
• Community Care Collaborative

  • Community/Behavioral Health Agency
  • Austin, TX
  • NPI 1720322068
  NPD (past)
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760745600000",
    "number": "1891022828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E CESAR CHAVEZ ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024209",
            "telephone_number": "512-978-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 COMAL ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024326",
            "telephone_number": "512-978-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LETICIA",
        "credential": "R.D.,L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETICIA",
            "last_name": "MCLEOD",
            "middle_name": "W",
            "credential": "R.D.,L.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaclyn Wallace
• Jason R. Wallace, M.D.
• Jenifer Wallace
• Joni K Wallace
• Lee Travis Wallace, PHD
• Lillian Wallace, PA
• Lisa Wallace, OT
• Mariah Lanai Wallace, RN
• Meredith Wallace
• Richard Scott Wallace, LCSW

• Registered Dietitian in Austin, TX
• Providers in Austin, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.