Leticia Kristin Wallace, RD,LD in West Lake Hills, TX - Medicare Dietitian, Registered Provider

Leticia Kristin Wallace, RD,LD is a medicare enrolled "Dietitian, Registered" provider in West Lake Hills, Texas. Her current practice location is 5656 Bee Caves Rd, West Lake Hills, Texas. You can reach out to her office (for appointments etc.) via phone at (512) 807-3270.

Leticia Kristin Wallace is licensed to practice in Texas (license number DT80777) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1891022828.

Contact Information

	Leticia Kristin Wallace, RD,LD
	5656 Bee Caves Rd, West Lake Hills, TX 78746-5280
	(512) 807-3270
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Leticia Kristin Wallace
Gender	Female
Speciality	Dietitian, Registered
Location	5656 Bee Caves Rd, West Lake Hills, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891022828
Provider Enumeration Date: 11/12/2009
Last Update Date: 06/25/2024

Medicare PECOS Information:

PECOS PAC ID: 2668796277
Enrollment ID: I20150129002476

Medical Identifiers

Medical identifiers for Leticia Kristin Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891022828	NPI	-	NPPES
8V5795	Other	TX	BCBS
207207601	Medicaid	TX

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	DT80777 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Leticia Kristin Wallace allows following entities to bill medicare on her behalf.

Provider Name	Scott & White Clinic
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1093779704 PECOS PAC ID: 8123923604 Enrollment ID: O20031223000640

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leticia Kristin Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Leticia Kristin Wallace, RD,LD Po Box 844658, Dallas, TX 75284-4658 Ph: (254) 724-2111	Leticia Kristin Wallace, RD,LD 5656 Bee Caves Rd, West Lake Hills, TX 78746-5280 Ph: (512) 807-3270

Reviews and Comments

Dietitian, Registered in West Lake Hills, TX

Kailyn Cavanaugh, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4613 Bee Cave Rd, 204, West Lake Hills, TX 78746 Phone: 512-732-2400
Amreen Bora, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3939 Bee Caves Rd Ste A204, West Lake Hills, TX 78746 Phone: 512-609-0598
Kamran Khan, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3939 Bee Caves Rd Ste A204, West Lake Hills, TX 78746 Phone: 512-953-3919
Wilfong Nutrition Limited Liability Company Dietitian Medicare: Not Enrolled in Medicare Practice Location: 303 Reveille Rd, West Lake Hills, TX 78746 Phone: 512-633-3009 Fax: 737-443-5958
Mrs. Anne L Wilfong, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 303 Reveille Rd, West Lake Hills, TX 78746 Phone: 512-843-1681 Fax: 737-443-5958
Olivia Friedrichs, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3939 Bee Caves Rd Ste A204, West Lake Hills, TX 78746 Phone: 512-609-0598
Jessica Smosna, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 5656 Bee Caves Rd, M300, West Lake Hills, TX 78746 Phone: 512-807-3270

Leticia Kristin Wallace, RD,LD - Medicare Dietitian in West Lake Hills, TX