NPI age
20 years
Enumerated 2005-10-03
● Active
Type 1 · Individual
DR. Mark S Wallis, M.D.
Wallis is 1 of 3 dermatology providers in Longview and 1 of 167 in Texas.
Primary specialty
Dermatology
Plus 5 subspecialties
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-03-07
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 167 active dermatology providers in Texas.
NPI age
20 years
↑ 3 yr above median (17 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
5
In the 56% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-10Enumerated in NPPES
2005
2026
Where they practice
Practice location
3535 N Fourth St Ste 400
Longview, TX 756050038
Mailing address
3535 N Fourth St Ste 400
Longview, TX 756050038
Specialties
-
Dermatology PrimaryThe highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased...
-
DermatologyA 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...
-
DermatologyA dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue...
-
DermatologyA dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these...
-
DermatologyA pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.
-
DermatologyProcedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 30076724 | DPS NUMBER |
| 01 (TX) | 45D0684764 | CLIA NUMBER |
| 01 (TX) | CID037095 | CIDC NUMBER |
| 01 (TX) | H6685 | MEDICAL LICENSE NUMBER |
| 01 (TX) | 04813881913 | MED. ED. NUMBER |
| 05 (TX) | 0898678-03 |
Practice context
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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