Unknown Individual – Neurological Surgery Physician, NPI 1003834680

Unknown Individual is a healthcare provider. based in Austin, Texas. specializing in Neurological Surgery Physician. They hold a License No. D5186 (TX). The NPI Number for Unknown Individual is 1003834680

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003834680
Phone
(512) 324-8300
Address
1400 N IH 35 STE 300
Deactivation Date
3 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
5123248300
Graduation Year
1968 (58 years ago)
PAC ID
1254384654
Group Practice PAC ID
0941333280
Professional Enrollment ID
I20050225000238
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1400 N IH 35 STE 300

    AUSTIN, TX 787011926

    Phone: (512) 324-8300

    Fax: (512) 324-8301

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $102.

Total Amount is formed as General ($102) + Research ($0) + Ownership ($0) = $102.

Last reported payment date: 2023-09-13 • Largest payer in this snapshot: Medtronic, Inc. ($102).

Total Amount

$102

General + Research + Ownership

Payments

1

Total payment records

General Amount

$102

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$102
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941333280View full group profile
NameSpecialtyState
Colorectal Surgery (Proctology)NH
Infectious DiseaseMI
Internal MedicineTX
-TX
-TX
G A S T R O E N T E R O L O G YTX
D E R M A T O L O G YTX
-NY
-TX
Orthopedic SurgeryTX

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1003834680 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Neurological Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Austin, Texas in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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