Unknown Individual – Interventional Pain Medicine Physician, NPI 1033301981

Interventional Pain Medicine Physician

Unknown Individual is a healthcare provider. based in Addison, Texas. specializing in Interventional Pain Medicine Physician. They hold a License No. L9971 (TX). The NPI Number for Unknown Individual is 1033301981

Main info

Organization

Inactive

23 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1033301981

Phone

(214) 506-2610

Address

17051 DALLAS PKWY

Deactivation Date

6 June 2022

Doctor Profile

Medical School Name

UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED

Secondary Phone

2148883900

Graduation Year

2003 (23 years ago)

PAC ID

2567528946

Group Practice PAC ID

8729383823

Professional Enrollment ID

I20090310000418

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

17051, Dallas Parkway, Addison, Dallas County, Texas, 75001, United States
STE 300
ADDISON, TX 750017105
Phone: (214) 506-2610
Type: Mailing
Dallas Parkway, Addison, Dallas County, Texas, 75001:75287, United States
ADDISON, TX 750017105
Phone: (214) 888-3900
Fax: (214) 888-3901
Type: Location

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 75001)

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Provider's Procedures

Unknown Individual performs procedures in Interventional Pain Medicine Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PHYSICAL MEDICINE AND REHABILITATIO	TX	62311	Injections of substances into lower or sacral spine	83	57

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: 8729383823View full group profile

Name	Specialty	State
MARK A. LEDOUX (MD)	Anesthesiology, Pain Management	TX
DR. NATHAN SCOTT WALTERS (M.D.)	Pain Management, Physical Medicine And Rehabilitation	TX

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?

Public records show Unknown Individual under NPI 1033301981.

What should I verify if Unknown Individual is listed inactive?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What services align with Unknown Individual's listing?

Unknown Individual's public classification highlights Interventional Pain Medicine Physician. Clinical services aligned with this taxonomy classification.

What city is tied to Unknown Individual?

The directory associates Unknown Individual with Addison, Texas. Check all listed addresses for suites or satellite offices.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.