Phyllis Wallace is one of 45 nurse anesthetists practicing in Conroe, Texas .
Phyllis Wallace practices with Mint Anesthesia, PLLC.
Registry record (NPPES)
NPI
1679708556
Type
Type 1 · Individual
Primary taxonomy
Nurse Anesthetist, Certified Registered · 367500000X
Address on file
6560 Fannin St
Enumerated
May 21, 2009
Record last updated
Jun 23, 2015
License states listed
TX
Medicare (CMS)
Enrollment
Medicare-enrolled in TXCertified Registered Nurse Anesthetist (CRNA)
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
690 S Loop 336 Suite 130Conroe , TX 77304
More nurse anesthetists in Conroe
Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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