MEDICARE: JAHNNAE MONIQUE WALLACE LMT

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	225700000X	Massage Therapist	MT141323	TX

General Provider Information

NPI Number	:	1790578516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAHNNAE MONIQUE WALLACE LMT

Provider Business Mailing Address
First Line	:	3111 N HOUSTON ST APT 2607
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-7890
Country	:	US
Telephone Number	:	469-560-6217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 N HOUSTON ST APT 2607
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-7890
Country	:	US
Telephone Number	:	469-560-6217
Fax Number	:

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

Provider Enumeration Date	:	05/24/2025
Last Update Date	:	05/24/2025

Similar Medicare Providers

1942219480 — MRS. SHWETA GAUTAM DAFTARY D.D.S
Practice Location Address:

6009 BELT LINE RD STE 100
DALLAS, TX
75254-7890

Practice Phone: 972-239-1998
Practice Fax: 972-239-8899

1982559571 — DANIELLE MORSE FNP-C
Practice Location Address:

4300 CONGRESS AVE
DALLAS, TX
75219-2523

Practice Phone: 786-471-7914
Practice Fax:

1518810092 — ASHLEY NICOLE WILKERSON PSYD
Practice Location Address:

2222 WELBORN ST
DALLAS, TX
75219-3993

Practice Phone: 214-559-5000
Practice Fax:

1194678201 — DR. MADELINE SCOTT PT, DPT
Practice Location Address:

3500 OAK LAWN AVE
DALLAS, TX
75219-4308

Practice Phone: 214-528-3378
Practice Fax:

1427909357 — LAUREN KERSEY
Practice Location Address:

2222 WELBORN ST
DALLAS, TX
75219-3924

Practice Phone: 214-559-5000
Practice Fax:

1508324856 — CHARITY COMFORT CARE SERVICES. LLC
Practice Location Address:

3838 OAK LAWN AVE STE 1000
DALLAS, TX
75219-4511

Practice Phone: 469-317-6216
Practice Fax: 832-390-2505

Directions to “ JAHNNAE MONIQUE WALLACE LMT” 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.