Wallis Dermatology Associates PLLC
NPI 1396945234 · Dermatology Physician · Longview, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wallis Dermatology Associates PLLC is a Dermatology Physician organization in Longview, TX (NPI 1396945234).
Provider details
- NPI number
- 1396945234
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Elizabeth Bowen, Credentialing Officer(903) 503-7330
- License
- H6685 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 1900 S Washington Ave Ste EMarshall, TX 75670-6845Phone: (903) 503-7330Fax: (903) 503-7336
- 2365 Three Lakes PkwyTyler, TX 75703Phone: (903) 991-4569Fax: (430) 227-8328
Registry dates
- Enumerated
- 2007-07-19
- Last updated
- 2026-02-13
- Certified
- 2026-02-13
Frequently asked questions
- What is Wallis Dermatology Associates PLLC's NPI number?
- Wallis Dermatology Associates PLLC's National Provider Identifier (NPI) is 1396945234, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wallis Dermatology Associates PLLC?
- Wallis Dermatology Associates PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Wallis Dermatology Associates PLLC located?
- Wallis Dermatology Associates PLLC's practice location on file with NPPES is 3535 N Fourth St Ste 400, Longview, TX 75605-0038.
- What is Wallis Dermatology Associates PLLC's phone number?
- The practice phone number listed in the NPPES registry for Wallis Dermatology Associates PLLC is (903) 757-3881.
- Does Wallis Dermatology Associates PLLC accept Medicare?
- Wallis Dermatology Associates PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Wallis Dermatology Associates PLLC?
- The authorized official listed on Wallis Dermatology Associates PLLC's NPPES record is Elizabeth Bowen, Credentialing Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wallis Dermatology Associates PLLC's NPI active?
- Yes — Wallis Dermatology Associates PLLC's NPI (1396945234) is active in the NPPES registry as of the last update on 2026-02-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.