Mark S Wallis (NPI# 1861489049, PAC ID# 7113057563) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1861489049 |
| PAC ID by PECOS | 7113057563 |
| Professional Enrollment ID | I20100610000658 |
| Full Name | Mark S Wallis |
| Organization Legal Name | WALLIS DERMATOLOGY ASSOCIATES PLLC |
| Address |
1111 N 6th St Longview TX 75601-5537 |
| Phone Number | 9032363266 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO |
| Graduation Year | 1988 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 0749440188 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1111 N 6th St, Longview, TX 75601-5537 | 9032363266 | WALLIS DERMATOLOGY ASSOCIATES PLLC |
| 6 Doctor Cir, Longview, TX 75605-5050 | 9037573881 | WALLIS DERMATOLOGY ASSOCIATES PLLC |
| Organization Legal Name | WALLIS DERMATOLOGY ASSOCIATES PLLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly L Calderon | Nurse Practitioner | Wallis Dermatology Associates Pllc | 6 Doctor Cir, Longview, TX 75605-5050 |
| Tammi M Short | Nurse Practitioner | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Herold S Osborne | Physician Assistant | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Robert S Taylor Iii | Dermatology | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Rachel M Smith | Physician Assistant | Wallis Dermatology Associates Pllc | 6 Doctor Cir, Longview, TX 75605-5050 |
| Laura P Fite | Dermatology | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Street Address |
1111 N 6TH ST |
| City | LONGVIEW |
| State | TX |
| Zip | 75601-5537 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tammi M Short | Nurse Practitioner | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Herold S Osborne | Physician Assistant | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Robert S Taylor Iii | Dermatology | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Laura P Fite | Dermatology | Wallis Dermatology Associates Pllc | 1111 N 6th St, Longview, TX 75601-5537 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daytral Matasha Brown | Nurse Practitioner | 103 Woodbine Pl A, The Beverly Clinic, Longview, TX 75601-2912 | |
| Andrea M Marjason | Clinical Social Worker | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Michelle Ann Vess | Physician Assistant | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Donald Winsted | Psychologist, Clinical | 103 Woodbine Pl A, Longview, TX 75601-2912 | |
| Courtney Elizabeth Treat | Physician Assistant | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Jeremiah R Sanders | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Carrie D Hinton | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Gracie M Adkisson | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Longview, TX 75601-2912 |
| Debbie L Anderson | Clinical Social Worker | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Thomas Jay Dehaven | Ophthalmology | Trinity Clinic | 1705 Judson Rd, Longview, TX 75601-2938 |
| Find all physicians in zip 75601 | |||
| City | LONGVIEW |
| Zip Code | 75601 |
| Specialty | DERMATOLOGY |
| City + Specialty | LONGVIEW + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.