PHYLLIS MARIE WALLACE (NPI# 1679708556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679708556 |
| Entity Type | Individual |
| Full Name | PHYLLIS MARIE WALLACE |
| Credential | CRNA |
| Practice Address |
6560 Fannin St Suite 600 Houston TX 77030-2761 |
| Mailing Address |
105 E. Sherwood Dr. Alvin TX 77511 |
| Practice Telephone | 7137960500 |
| Mailing Telephone | 8326216220 |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2015-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 561885 | TX | Nursing Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | AP117949 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366486417 | Phyllis A Wallace | Nurse Practitioner | 527 W 3rd St, Konawa, OK 74849-1415 | 2006-06-16 |
| Street Address |
6560 FANNIN ST SUITE 600 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030-2761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891797130 | Terry D Taylor | Dentist | 6560 Fannin St, Ste 614, Houston, TX 77030-2727 | 2005-06-01 |
| 1275182701 | Maria Graziela Putnam | Pharmacist | 6560 Fannin St, Houston, TX 77030-2761 | 2019-09-07 |
| 1205488285 | Danish Kherani | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Houston, TX 77030-2761 | 2019-07-10 |
| 1497216477 | Sanaa A Karim | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Houston, TX 77030-2761 | 2019-03-30 |
| 1477070944 | Line Kastrup Hinojosa | Nurse Practitioner | 6560 Fannin St, Houston, TX 77030-2761 | 2017-08-25 |
| 1669905410 | Bradley Steven Daniels | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, #900, Houston, TX 77030-2761 | 2017-04-09 |
| 1609308279 | Samuel Kwabena Asante | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Scurlock Tower, 9th Floor (st944), Houston, TX 77030-2761 | 2017-04-01 |
| 1437680204 | Kenan Celtik | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Suite 2100, Houston, TX 77030-2761 | 2017-03-23 |
| 1124568324 | Samantha Boggs | Nurse Practitioner | 6560 Fannin St, Suite 2050, Houston, TX 77030-2761 | 2017-03-07 |
| 1518419969 | Taryn Marie Sheldon | Physician Assistant | 6560 Fannin St, Suite 1842, Houston, TX 77030-2761 | 2016-11-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
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| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376155887 | Health Guard Anesthesia Services (hgas) | Nurse Anesthetist, Certified Registered | 7741 Tanglewilde St Ste 100, Houston, TX 77036-5565 | 2020-08-18 |
| 1952911661 | Anesthesia Providers of Houston Pllc | Nurse Anesthetist, Certified Registered | 1446 Campbell Rd Ste 290, Houston, TX 77055-4604 | 2020-08-06 |
| 1962042275 | Leah Okoth | Nurse Anesthetist, Certified Registered | 3121 Buffalo Speedway Apt 7409, Houston, TX 77098-1860 | 2020-01-14 |
| 1508332362 | Houston Metro Anesthesia, Pa | Nurse Anesthetist, Certified Registered | 7789 Southwest Fwy Ste 200, Houston, TX 77074-1831 | 2018-10-19 |
| 1346739810 | Amy Celeste Metoyer | Nurse Anesthetist, Certified Registered | 6703 Winton St, Houston, TX 77021-2428 | 2018-05-09 |
| 1255835328 | Greater Heights Anesthesia, Pllc | Nurse Anesthetist, Certified Registered | 1631 North Loop W Ste 655, Houston, TX 77008-1599 | 2018-03-22 |
| 1073012068 | Brandon C. Cervantes | Nurse Anesthetist, Certified Registered | 1500 Citywest Blvd. Ste. 300, Houston, TX 77042 | 2018-02-06 |
| 1639685407 | Momentum Anesthesia Group Pllc | Nurse Anesthetist, Certified Registered | 1233 Campbell Rd Ste 200, Houston, TX 77055-6453 | 2017-12-15 |
| 1245683309 | Crystal Anesthesia Service, Pllc | Nurse Anesthetist, Certified Registered | 950 Threadneedle St Ste 250, Houston, TX 77079-2910 | 2016-07-13 |
| 1972964476 | Josipa Kukucka | Nurse Anesthetist, Certified Registered | 2014 Dennis St, Houston, TX 77004-1322 | 2016-03-10 |
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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.