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General NPI Number Information
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NPI Number | 1942832043
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Entity Type | Individual
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Provider Name | KRISTEN JENNIFER WALLING PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 2915 W BITTERS RD STE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78248-2007
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Country | US
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Telephone | 210-598-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 7105 CREIGHTON LN
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City | AUSTIN
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State | TX
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Zip | 78723-1539
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Country | US
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Telephone | 609-721-8667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9112842
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License Number State | FL
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