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WYRICK DERMATOLOGY ASSOCIATION
NPI 1619977295
Clinic/Center in Texarkana, TX

Active since July 26, 2005CLIA 45D0482485 · Microscopy
3333 POTOMAC AVE, TEXARKANA, TX 75503(903) 792-3787(903) 792-0446 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Wyrick Dermatology Association NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WYRICK DERMATOLOGY ASSOCIATION (NPI 1619977295) is a healthcare organization registered as a clinic/center in Texarkana, Texas and active in the NPI registry since July 2005. The organization holds a CLIA Microscopy certificate valid through August 31, 2028 and lists Scott W Wyrick, President, as its authorized official.

NPPES Registry Identity

NPI1619977295
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameWYRICK DERMATOLOGY ASSOCIATION
Location Address3333 POTOMAC AVETexarkana, TX 75503-3513
Mailing Address3333 Potomac AveTexarkana, TX 75503-3513 · (903) 792-3787 · Fax (903) 792-0446
Phone(903) 792-3787
Fax(903) 792-0446
Organization SubpartNo
Authorized OfficialScott W WyrickPresident · (903) 792-3787
Enumeration DateJuly 26, 2005
Last NPPES UpdateSeptember 2, 2026
NPPES CertifiedSeptember 2, 2026
✔ NPI 1619977295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
3333 POTOMAC AVE, Texarkana, TX 75503
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Other Identifiers 2

Medicaid109371802TX
Medicaid145002002AR

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wyrick Dermatology Association is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wyrick Dermatology Association, which bills Medicare for the services this clinician delivers.

Clinician (1)

Scott Wyrick, M.D.
Family Practice
NPI 1114920972
3333 POTOMAC AVE
Texarkana, TX 75503
(903) 792-3787
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0482485

Wyrick Dermatology Assn · Texarkana, TX
Active · expires Aug 31, 2028
CLIA Number45D0482485
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorWalter Wyrick Jr MD
Laboratory Phone(903) 792-3787
Laboratory LocationWyrick Dermatology Assn3333 Potomac Avenue, Texarkana, TX 75503
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wyrick Dermatology Association's NPI number?

The NPI number for Wyrick Dermatology Association is 1619977295. It was assigned to this organization in the NPPES registry on July 26, 2005.

Where is Wyrick Dermatology Association located?

Wyrick Dermatology Association is located at 3333 Potomac Ave, Texarkana, TX 75503. The listed phone number is (903) 792-3787.

What is Wyrick Dermatology Association's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Wyrick Dermatology Association enrolled in Medicare?

Yes. Wyrick Dermatology Association is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wyrick Dermatology Association?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Wyrick Dermatology Association. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wyrick Dermatology Association hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0482485) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wyrick Dermatology Association was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.