Mark S Wallis is a MOHS-Micrographic Surgery Physician based in Longview, TX and is specialized in MOHS-Micrographic Surgery. Mark S Wallis practices in Longview, TX and has the professional credentials of MD. The NPI Number for Mark S Wallis is 1861489049 and holds a License No. H6685 (Texas).
The current practice location address for Mark S Wallis is 3535 N Fourth St Ste 400, Longview, TX and can be reached out via phone at 903-757-3881 and via fax at 903-757-5948.
Location: 3535 N Fourth St Ste 400, Longview, TX, 75605-0038
Provider Profile Details
NPI Number
1861489049
Provider Name
Mark S Wallis
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3535 N Fourth St Ste 400, Longview, TX, 75605-0038
Phone Number
903-757-3881
Fax Number
903-757-5948
Provider Enumeration Date
10/03/2005
Last Update Date
03/08/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30076724 | 01 | TX | DPS NUMBER |
| 45D0684764 | 01 | TX | CLIA NUMBER |
| CID037095 | 01 | TX | CIDC NUMBER |
| H6685 | 01 | TX | MEDICAL LICENSE NUMBER |
| 04813881913 | 01 | TX | MED. ED. NUMBER |
| 0898678-03 | 05 | TX |
Provider Business Practice Location Address Details
Address
3535 N Fourth St Ste 400
City
State
Zip
75605-0038
Phone Number
903-757-3881
Fax Number
903-757-5948
Provider Business Mailing Address Details
Address
3535 N Fourth St Ste 400
City
State
Zip
75605-0038
Phone Number
903-757-3881
Fax Number
903-757-5948
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
-
Taxonomy
License No.
H6685 (Texas)
Definition
A 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 dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
MOHS-Micrographic Surgery
Taxonomy
License No.
H6685 (Texas)
Definition
The 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 tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
Dermatopathology
Taxonomy
License No.
H6685 (Texas)
Definition
A 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 sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
Provider's Taxonomy Details 4
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
Clinical & Laboratory Dermatological Immunology
Taxonomy
License No.
H6685 (Texas)
Definition
A 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 disorders and administer specialized forms of therapy for these diseases.
Provider's Taxonomy Details 5
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
Pediatric Dermatology
Taxonomy
License No.
H6685 (Texas)
Definition
A 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.
Provider's Taxonomy Details 6
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
Procedural Dermatology
Taxonomy
License No.
H6685 (Texas)
Definition
Procedural 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, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
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