Dr Mark S Wallis, MD in Longview, TX

Dr Mark S Wallis, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Longview, Texas. He went to University Of Texas Medical School At San Antonio and graduated in 1988 and has 36 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Wallis Dermatology Associates Pllc and his current practice location is 3535 N Fourth St Ste 400, Longview, Texas. You can reach out to his office (for appointments etc.) via phone at (903) 757-3881.

Dr Mark S Wallis is licensed to practice in Texas (license number H6685) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1861489049.

Contact Information

	Dr Mark S Wallis, MD
	3535 N Fourth St Ste 400, Longview, TX 75605-0038
	(903) 757-3881
	(903) 757-5948

Map and Direction

Physician's Profile

Full Name	Dr Mark S Wallis
Gender	Male
Speciality	Dermatology
Experience	36 Years
Location	3535 N Fourth St Ste 400, Longview, Texas
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Mark S Wallis attended and graduated from University Of Texas Medical School At San Antonio in 1988

NPI Data:

NPI Number: 1861489049
Provider Enumeration Date: 10/03/2005
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 7113057563
Enrollment ID: I20100610000658

Medical Identifiers

Medical identifiers for Dr Mark S Wallis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861489049	NPI	-	NPPES
30076724	Other	TX	DPS NUMBER
45D0684764	Other	TX	CLIA NUMBER
CID037095	Other	TX	CIDC NUMBER
H6685	Other	TX	MEDICAL LICENSE NUMBER
04813881913	Other	TX	MED. ED. NUMBER
0898678-03	Medicaid	TX

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	H6685 (Texas)	Secondary
207ND0900X	Dermatology - Dermatopathology	H6685 (Texas)	Secondary
207NI0002X	Dermatology - Clinical & Laboratory Dermatological Immunology	H6685 (Texas)	Secondary
207NP0225X	Dermatology - Pediatric Dermatology	H6685 (Texas)	Secondary
207NS0135X	Dermatology - Procedural Dermatology	H6685 (Texas)	Secondary
207ND0101X	Dermatology - Mohs-micrographic Surgery	H6685 (Texas)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Wallis Dermatology Associates Pllc	0749440188	8

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mark S Wallis allows following entities to bill medicare on his behalf.

Entity Name	Wallis Dermatology Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396945234 PECOS PAC ID: 0749440188 Enrollment ID: O20120322000343

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark S Wallis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mark S Wallis, MD 3535 N Fourth St Ste 400, Longview, TX 75605-0038 Ph: (903) 757-3881	Dr Mark S Wallis, MD 3535 N Fourth St Ste 400, Longview, TX 75605-0038 Ph: (903) 757-3881

Reviews and Comments

Dermatology Doctors in Longview, TX

Luke Stewart Wallis, MD Dermatology Medicare: Medicare Enrolled Practice Location: 3535 N Fourth St Ste 400, Longview, TX 75605 Phone: 903-757-3881 Fax: 903-757-5948
Matthew Thomas Hoffmann, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1402 N 4th St, Longview, TX 75601 Phone: 903-757-8878 Fax: 903-757-5985
Dr. Robert Stanley Taylor Iii, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3535 N Fourth St Ste 400, Longview, TX 75605 Phone: 903-757-3881 Fax: 903-757-5948
Laura Paul Fite, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3535 N Fourth St Ste 400, Longview, TX 75605 Phone: 903-757-3881 Fax: 903-757-5948
Dr. Donna Vu, Dermatology Medicare: Not Enrolled in Medicare Practice Location: 6 Doctor Cir, Longview, TX 75605 Phone: 903-757-3881 Fax: 903-757-5948

Dr Mark S Wallis, MD - Medicare Dermatology in Longview, TX