NPI age
10 years
Enumerated 2015-10-13
● Active
Type 1 · Individual
Rafaella Izar Wallace, ANP
Wallace is 1 of 32 nurse practitioner providers in Fort Worth and 1 of 1011 in Texas.
Primary specialty
Nurse Practitioner
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-12-01
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1011 active nurse practitioner providers in Texas.
NPI age
10 years
↑ 4 yr above median (6 yr)
State licenses
1 state
6% of peers hold multiple states
Subspecialties
1
In the 40% of peers with subspecialties
NPI lifetime · 2015 → 2026
2015-10Enumerated in NPPES
2015
2026
Where they practice
Practice location
500 S Henderson St Ste 200
Fort Worth, TX 761042154
Mailing address
Po Box 911230
Dallas, TX 753911230
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
-
Nurse PractitionerDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 365509402 | |
| 01 (TX) | 8449NZ | BLUE CROSS BLUE SHIELD |
Practice context
Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new nurse practitioner provider has been added in Fort Worth in the last 180 days.
See all →
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.