MS. MARY ELISE WALLACE (NPI# 1013451608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013451608 |
| Entity Type | Individual |
| Full Name | MS. MARY ELISE WALLACE |
| Credential | MSRD/LD |
| Practice Address |
3600 Gaston Ave Suite 656 Dallas TX 75246-1800 |
| Mailing Address |
3812 Elm St Dallas TX 75226-1216 |
| Practice Telephone | 2148203896 |
| Mailing Telephone | 2148204752 |
| Mailing Fax Number | 2148204853 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DT03189 | TX | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528585031 | Mary Wallace | Psychologist | 1605 E Ash St, Canton, IL 61520-1510 | 2017-08-25 |
| 1801136809 | Mary Etheridge Wallace | Counselor | 303 E. Main Street Suite 9, Elizabeth City, NC 27909 | 2013-02-27 |
| 1851541163 | Mary Caroline Wallace | Speech-Language Pathologist | 5 5th St Se, Washington, DC 20003-1119 | 2008-09-23 |
| 1245446723 | Mary Frances Wallace | Massage Therapist | 3301 River Ave, Huntington, WV 25705-2807 | 2007-05-14 |
| 1134253396 | Mary Beth Wallace | Speech-Language Pathologist | 2461 Highway 1, Harrisburg, AR 72432-9479 | 2007-03-16 |
| 1619045648 | Mary D Wallace | Social Worker | 105 Broadview Dr, Syracuse, NY 13215-1505 | 2006-11-30 |
| 1982156766 | Mary Terese Wallace | Dietitian, Registered | 700 Broadway, Seattle, WA 98122-4302 | 2016-10-27 |
| 1194173443 | Mary Wallace | Case Manager/Care Coordinator | 627 S Elliott Ave, Wenatchee, WA 98801-3195 | 2016-05-27 |
| 1255760898 | Mary Wallace | Counselor | 1818 Se Division St, Portland, OR 97202-1159 | 2013-11-04 |
| 1811127947 | Mary Virginia Wallace | Social Worker | 1401 N Central Expy, Suite 375, Richardson, TX 75080-4669 | 2009-07-23 |
| Street Address |
3600 GASTON AVE SUITE 656 |
| City | DALLAS |
| State | TX |
| Zip Code | 75246-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215429 | Norman Slusher | Ophthalmology | 3600 Gaston Ave, Ste 964, Dallas, TX 75246-1909 | 2005-06-14 |
| 1669032561 | Julia Przybyszewski | Physician Assistant | 3600 Gaston Ave, Dallas, TX 75246-1800 | 2019-06-13 |
| 1164934865 | Stephen Daniel Krivan | Physician Assistant | 3600 Gaston Ave, Wadley Tower Suite 550, Dallas, TX 75246 | 2017-11-02 |
| 1508226382 | Jessica Osipenko | Nurse Practitioner | 3600 Gaston Ave, Wadley Tower, Suite 960, Dallas, TX 75246-1800 | 2016-03-07 |
| 1952773178 | Erin Davidson | Pharmacist | 3600 Gaston Ave, Suite 109, Dallas, TX 75246-1800 | 2015-10-27 |
| 1871960146 | Krista Heinrich | Pharmacist | 3600 Gaston Ave, Suite 109, Dallas, TX 75246-1800 | 2015-08-21 |
| 1417339177 | Jami Mckinney | Physician Assistant | 3600 Gaston Ave, Suite 550, Dallas, TX 75246-1800 | 2015-06-18 |
| 1780065755 | Evan Koesler | Physician Assistant | 3600 Gaston Ave, Suite 550, Dallas, TX 75246-1800 | 2015-06-15 |
| 1851772958 | Alexandra Lee Bewley | Physician Assistant | 3600 Gaston Ave, Suite 550, Dallas, TX 75246-1800 | 2015-06-15 |
| 1972984953 | Michelle Nickelatti | Physician Assistant | 3600 Gaston Ave, Wadley Ste 550, Dallas, TX 75246-1800 | 2015-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396201356 | Roseann Estrada Mendoza | Nurse Practitioner | 3600 Gaston Ave., Barnett Tower, Suite 711, Dallas, TX 75246 | 2019-02-14 |
| 1033683701 | Marta Revilla-leon | Dentist | 3302 Gaston Avenue, College of Dentistry, Texas A&m Uni, Room 713, Dallas, TX 75246 | 2019-01-16 |
| 1912408170 | Liza Johannesson | Transplant Surgery | Baylor University Medical Center, 3410 Worth Street, Ste 950, Dallas, TX 75246 | 2018-02-23 |
| 1841710266 | Stephanie Chartier-plante | Student in an Organized Health Care Education/Training Program | 3501 Junius St, Jonsson Hospital, Dallas, TX 75246 | 2017-06-27 |
| 1528505096 | Adam Bohnenblust | Chiropractor | 411 N Washington Ave Ste 2200, Dallas, TX 75246 | 2017-01-23 |
| 1699121327 | Magnolia Pain Associates Pllc | Pain Medicine | 3801 Gaston Ave Ste 318- 320, Dallas, TX 75246 | 2016-05-12 |
| 1073969408 | Apurva Yeluru | Hospitalist | 3500 Gaston Ave Ste 550, Dallas, TX 75246 | 2016-05-04 |
| 1134580533 | Sp Alf Ops Co, LLC | Assisted Living Facility | 3922 Simpson Street, Dallas, TX 75246 | 2016-03-11 |
| 1386031185 | Lisa Voigt | Student in an Organized Health Care Education/Training Program | 3501 Junius Street, Dallas, TX 75246 | 2015-04-20 |
| 1891107843 | Jessica Shie | Internal Medicine | Baylor Scott & White - Hospital Medicine Dallas, 3600 Gaston Ave., Wadley #550, Dallas, TX 75246 | 2014-05-27 |
| Find all providers in zip 75246 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902637 | Allison Kleppe | Dietitian, Registered | 6255 Oram St Apt 106, Dallas, TX 75214-3985 | 2020-11-08 |
| 1720699945 | Brenna Mcconniel | Dietitian, Registered | 6071 Village Bend Dr Apt 103, Dallas, TX 75206-3502 | 2020-08-11 |
| 1891305314 | Patricia Rose Morrison | Dietitian, Registered | 8806 Redondo Dr, Dallas, TX 75218-4142 | 2020-08-10 |
| 1093324592 | Kara Osburn | Dietitian, Registered | 3300 Oak Lawn Ave Ste 102, Dallas, TX 75219-4236 | 2020-07-30 |
| 1083222020 | Reena Woolley | Dietitian, Registered | 5747 Sadler Cir Apt 2329, Dallas, TX 75235-6618 | 2020-07-15 |
| 1255949376 | Nicole Finken | Dietitian, Registered | 2121 N Pearl St, Dallas, TX 75201-2492 | 2020-07-14 |
| 1407473879 | Lauren Taylor Lund | Dietitian, Registered | 5219 Maple Ave Apt 2209, Dallas, TX 75235-7466 | 2020-07-01 |
| 1437774247 | Brittany A Crump | Dietitian, Registered | 2121 N Pearl St Ste 300, Dallas, TX 75201-2494 | 2020-06-08 |
| 1417571886 | Taylor Morrison | Dietitian, Registered | 4429 Hyer St, Dallas, TX 75205-1050 | 2020-06-02 |
| 1457974057 | Cammie Sharp | Dietitian, Registered | 17060 Dallas Pkwy Ste 213, Dallas, TX 75248-1900 | 2020-05-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.