MEDICARE: JENIFER WALLACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1568395044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENIFER WALLACE

Provider Business Mailing Address
First Line	:	4201 W PARMER LN BLDG C
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 W PARMER LN BLDG C
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4109
Country	:	US
Telephone Number	:	512-808-0237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

Similar Medicare Providers

1346341005 — DR. MARK A FLOOD D.O.
Practice Location Address:

4201 W PARMER LN , BUILDING A, SUITE 275
AUSTIN, TX
78727-4109

Practice Phone: 512-834-1300
Practice Fax:

1790926715 — J&M DIAGNOSTICS, LLC
Practice Location Address:

4201 W PARMER LN , BLDG C, SUITE 150
AUSTIN, TX
78727-4109

Practice Phone: 214-701-5447
Practice Fax: 214-279-0528

1992240758 — MS. CHRISTINE NICOLA NP
Practice Location Address:

4201 W PARMER LN STE 175
AUSTIN, TX
78727-4109

Practice Phone: 737-263-2656
Practice Fax:

1922600444 — CHAD JOHNSON
Practice Location Address:

4201 W PARMER LN STE 175
AUSTIN, TX
78727-4109

Practice Phone: 855-204-2502
Practice Fax:

1841916970 — MICHELLE C JONES LMFT
Practice Location Address:

4201 W PARMER LN
AUSTIN, TX
78727-4109

Practice Phone: 800-930-0803
Practice Fax:

1548085020 — SERENA MCCALEB
Practice Location Address:

4201 W PARMER LN STE 250
AUSTIN, TX
78727-4109

Practice Phone: 512-808-0237
Practice Fax:

Directions to “ JENIFER WALLACE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.