| Luke Stewart Wallis, MD | |
|
3535 N Fourth St Ste 400, Longview, TX 75605-0038 | |
| (903) 757-3881 | |
| (903) 757-5948 |
| Full Name | Luke Stewart Wallis |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 3535 N Fourth St Ste 400, Longview, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144724717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 1144724717 (Texas) | Primary |
| 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 |
| Mailing Address | Practice Location Address |
|---|---|
| Luke Stewart Wallis, MD 3535 N Fourth St Ste 400, Longview, TX 75605-0038 Ph: (903) 757-3881 | Luke Stewart Wallis, MD 3535 N Fourth St Ste 400, Longview, TX 75605-0038 Ph: (903) 757-3881 |
Mrs. Taylor Griffin Dickerson, 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 | |
Blake A Robbins, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 707 Hollybrook Dr, Longview, TX 75605 Phone: 903-232-8230 Fax: 903-232-8236 | |
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 | |
Dr. Mark S Wallis, 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 | |
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 |