Individual provider · Type 1 NPI
Carla Dennise Wallace, A-GNP-C
Gerontology Nurse Practitioner · Pearland, TX
NPI number
1164122149
Active
Practice location
2421 Copper Sky Dr
Pearland, TX 77584-3782
Fax (877) 673-2947
Other practice locations
- 3129 Kingsley Dr Ste 1940, Pearland, TX 77584-8511 · (346) 502-2837
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 1095104 (TX) |
Gerontology Nurse Practitioner: Definition to come...
Another provider at this address
Other gerontology nurse practitioner providers in Pearland
About NPI 1164122149
Carla Dennise Wallace, A-GNP-C's National Provider Identifier is 1164122149, issued on Mar 7, 2023. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Pearland, TX. The record was last updated on Feb 20, 2026.