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Wallis Dermatology Associates Pllc

Dermatology Physician in Longview, TX · enumerated 2007 · authorized official Elizabeth Bowen, Credentialing Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1396945234

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Registry record

Entity type Organization (Type 2)
Legal business name Wallis Dermatology Associates Pllc
Practice address 3535 N Fourth St Ste 400, Longview, TX, 75605
Phone (903) 757-3881
Fax (903) 757-5948
Enumeration date Jul 19, 2007
Last updated in NPPES Feb 13, 2026

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians · License H6685 (TX) Primary

Authorized official

Name Elizabeth Bowen
Title Credentialing Officer
Phone (903) 503-7330

Other identifiers

Identifier Type State Issuer
302333501 Medicaid TX -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Wallis Dermatology Associates Pllc?
The NPI for Wallis Dermatology Associates Pllc is 1396945234, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Wallis Dermatology Associates Pllc?
NPPES lists Elizabeth Bowen (Credentialing Officer) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-02-13.