Wallis Dermatology Associates PLLC
NPI 1396945234ActiveOrganization· Dermatology· Longview, TX
Dermatology in Longview, Texas, registered in NPPES in July 2007. The authorized official on file is Elizabeth Bowen, Credentialing Officer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1396945234 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 19, 2007 |
| Last updated in NPPES | Feb 13, 2026 |
| Certified by provider | Feb 13, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | H6685 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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