DR. DANIEL THEODORE WALLIS (M.D.) – Dermatology Physician, NPI 1871957076
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,284 DERMATOLOGY in TX
Provider Addresses for DR. DANIEL THEODORE WALLIS (M.D.)
3601 4th St
Lubbock, TX 794304402
Phone: (806) 743-1842
Type: Location
Texas Tech Health Sciences Center, 3601, 4th Street, Lubbock, Lubbock County, Texas, 79415, United States
LUBBOCK, TX 794300002
Phone:
Type: Mailing
7832 PAT BOOKER RD
LIVE OAK, TX 782332601
Phone: (210) 657-9338
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 240 Open Payments records for all available years, with a total value of $4,657.
Total Amount is formed as General ($4,657) + Research ($0) + Ownership ($0) = $4,657.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($657).
Total Amount
$4,657
General + Research + Ownership
Payments
240
Total payment records
General Amount
$4,657
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $657 |
| E.R. Squibb & Sons, L.L.C. | $635 |
| Amgen Inc. | $430 |
| PFIZER INC. | $282 |
| Janssen Biotech, Inc. | $207 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-07-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200716001095 | I | Dermatology | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 2,204 | 310 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 854 | 573 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 584 | 387 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 352 | 302 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 237 | 155 | $0 |
Insurance plans in this area (ZIP 79430)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TX | |
| D E R M A T O L O G Y | TX | |
| Physician Assistant | TX | |
| D E R M A T O L O G Y | TX | |
| Interventional Radiology, Diagnostic Radiology | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| D E R M A T O L O G Y | TX | |
| Physician Assistant | AZ |
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