Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Mary Elise Wallace, MSRD/LD

Individual provider Registered Dietitian · NPI 1013451608

MS. Mary Elise Wallace, MSRD/LD is a Registered Dietitian in Rockwall, Texas. Works from 2 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2016
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Practice location Address checks out

6705 Heritage Pkwy Ste 104
Rockwall, TX 75087-8729
Phone: (972) 412-7700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3600 Gaston Ave, Dallas, TX 75246-1800 — (214) 820-3896

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence DT03189 (TX)

Record details

NPI number1013451608
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSRD/LD
Sole proprietorNo
NPI enumeratedDecember 15, 2016
Last updated in NPPESAugust 12, 2021
Certification dateAugust 12, 2021

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