NPI age
18 years
Enumerated 2007-07-19
● Active Type 2 · Organization
Wallis Dermatology Associates Pllc
Wallis Dermatology Associates Pllc is 1 of 1632 dermatology organizations in Texas.
Primary specialty
Dermatology
Practice locations
3
2 secondary on file
Status
Active
No deactivations on record
Authorized official
Bowen
Credentialing Officer
Last NPPES update
2026-02-13
Source: monthly bulk 2026-05
How this organization compares
Across 1632 active dermatology providers in Texas.
NPI age
18 years
↑ 2 yr above median
Practice locations
3
2 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-07Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
3535 N Fourth St Ste 400
Longview, TX 756050038
Mailing address
3535 N Fourth St Ste 400
Longview, TX 756050038
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
1900 S Washington Ave Ste E
Marshall, TX 756706845
Location 3
2365 Three Lakes Pkwy
Tyler, TX 75703
Authorized official
Elizabeth Bowen
Credentialing Officer
📞 9035037330
Individual providers at this organization
10 individual providers on file at this primary practice address.
- Taylor Dickerson, MD Dermatology NPI 1154825974
- Casey English, APRN-CNP Nurse Practitioner NPI 1780259135
- Laura Fite, M.D. Dermatology NPI 1861750416
- Herold Osborne, P.A-C Physician Assistant NPI 1710999727
- Tammi Short, FNP-C Nurse Practitioner NPI 1538137153
- Rachel Smith, P.A. Physician Assistant NPI 1851323919
- Robert Taylor, MD Dermatology NPI 1760441893
- Luke Wallis, MD Dermatology NPI 1144724717
- Mark Wallis, M.D. Dermatology NPI 1861489049
- Dorothy Womack, FNP-C Nurse Practitioner NPI 1003590282
Specialties
-
Dermatology PrimaryA dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 302333501 |
Practice context
Multi-provider organization. 10 individual providers on file at this primary address. Plus 2 secondary practice locations.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.