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

Dr. Daniel Theodore Wallis, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1871957076

Dr. Daniel Theodore Wallis, MD is a Dermatology in Live Oak, Texas. Graduated from University of Arkansas College of Medicine in 2016, 10 years ago. Practices with Dermatology Associates of San Antonio, a 17-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
10
Trained at
University of Arkansas College of Medicine
Licensed in
TX
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

7832 Pat Booker Rd
Live Oak, TX 78233-2601
Phone: (210) 657-9338
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3601 4th St, Lubbock, TX 79430-4402 — (806) 743-1842

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence S7577 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence BP10056054 (TX)

Record details

NPI number1871957076
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 13, 2016
Last updated in NPPESAugust 11, 2021
Certification dateAugust 11, 2021
Mailing address7832 Pat Booker Rd, Live Oak, TX 78233-2601

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Dermatology Associates Of San Antonio — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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