Unknown Individual – Family Medicine Physician, NPI 1023179207

Unknown Individual is a healthcare provider. based in Magnolia, Texas. specializing in Family Medicine Physician. They hold a License No. G5744 (TX). The NPI Number for Unknown Individual is 1023179207

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023179207
Phone
(281) 356-2900
Address
827 S. MAGNOLIA BLVD
Deactivation Date
21 February 2024

Doctor Profile

Medical School Name
TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
Secondary Phone
8323553575
Graduation Year
1983 (43 years ago)
PAC ID
0446245435
Group Practice PAC ID
9133213192
Professional Enrollment ID
I20070828000760
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

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Provider Addresses for Unknown Individual

  • Magnolia, Town of Magnolia, Rock County, Wisconsin, United States

    SUITE 6

    MAGNOLIA, TX 77355

    Phone: (281) 356-2900

    Fax: (281) 356-5830

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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 77355)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINETX81002Urinalysis, manual test11689

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: 9133213192View full group profile
NameSpecialtyState
-TX
Interventional Cardiology, Cardiovascular Disease (Cardiology)TX
Cardiovascular Disease (Cardiology)TX
Nurse PractitionerTX
Internal Medicine, Infectious DiseaseTX
Internal MedicineTX
Family PracticeTX
-TX
Pulmonary DiseaseMO
Interventional CardiologyTX

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1023179207 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Magnolia, Texas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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