Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Imelda V Wallace, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1003541095

Imelda V Wallace, FNP-BC is a Nurse Practitioner in El Paso, Texas. Qualified in 2022, 4 years ago. Practices with Rio Grande Urology PA, a 28-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2022
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

11860 Vista Del Sol Dr Ste 150
El Paso, TX 79936-6128
Phone: (915) 808-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2022000137 (TX)

Record details

NPI number1003541095
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJuly 22, 2022
Last updated in NPPESJuly 22, 2022
Certification dateJuly 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Rio Grande Urology Pa — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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