Individual provider Active NPI

Eric Willis

  • Dermatology Physician
  • Live Oak, TX
National Provider Identifier
1477040038
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
T7083 Issued in TX
Practice address
7832 Pat Booker Rd
Live Oak, TX 78233-2601
Phone
(210) 657-9338
Fax
(210) 729-7486
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X T7083 TX Primary

Addresses

Primary practice location

7832 Pat Booker Rd
Live Oak, TX 78233-2601

Mailing address

7832 Pat Booker Rd
Live Oak, TX 78233-2601
Phone (210) 657-9338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823000171 TX Practitioner - Dermatology 2062746290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of San AntonioGroup PAC ID 1759319296, 17 clinicians
Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

7832 Pat Booker Rd
Live Oak, TX 78233-2601
Phone (210) 657-9338

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Removal of skin lesions343
Removal or shaving of skin growth14
Skin biopsy120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T7083TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of San Antonio Dermatology CurrentSince Oct 1, 2024 Accepting new patients
Epiphany Dermatology PA Dermatology CurrentSince Oct 1, 2025 Accepting new patients

Locations

7300 Ranch Road 2222
Bldg 1
Austin, TX 78730

7832 Pat Booker Rd
Live Oak, TX 78233
Phone (210) 657-9338

18540 Sigma Rd
San Antonio, TX 78258
Phone (210) 490-4661

Interoperability endpoints

  • Direct secure messaging: eric.willis.p1@direct.dermsa.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1477040038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7832 PAT BOOKER RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332601",
            "telephone_number": "210-657-9338",
            "fax_number": "210-729-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7832 PAT BOOKER RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332601",
            "telephone_number": "210-657-9338",
            "fax_number": "210-729-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "T7083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.