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

Dr. Mark S Wallis, MD

Individual provider Dermatology Physician · NPI 1861489049

Dr. Mark S Wallis, MD is a Dermatology in Longview, Texas. Graduated from University of Texas Medical School at San Antonio in 1988, 38 years ago. Practices with Wallis Dermatology Associates PLLC, an 11-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
38
Trained at
University of Texas Medical School at San Antonio
Licensed in
TX
In the registry since
2005
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3535 N Fourth St Ste 400
Longview, TX 75605-0038
Phone: (903) 757-3881
Fax: (903) 757-5948
Show map & directions

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

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence H6685 (TX)
Dermatology Physician Taxonomy 207N00000X · Licence H6685 (TX)
Dermatopathology Physician Taxonomy 207ND0900X · Licence H6685 (TX)
Clinical & Laboratory Dermatological Immunology Physician Taxonomy 207NI0002X · Licence H6685 (TX)
Pediatric Dermatology Physician Taxonomy 207NP0225X · Licence H6685 (TX)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence H6685 (TX)

Record details

NPI number1861489049
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 3, 2005
Last updated in NPPESMarch 7, 2023
Certification dateJuly 21, 2021
Mailing address3535 N Fourth St Ste 400, Longview, TX 75605-0038

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduated 1988 (38 years in practice)
Group practice Wallis Dermatology Associates Pllc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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