Unknown Individual – Internal Medicine Physician, NPI 1053340422

Unknown Individual is a healthcare provider. based in Austin, Texas. specializing in Internal Medicine Physician. They hold a License No. R1863 (TX). The NPI Number for Unknown Individual is 1053340422

Main info

Organization
Inactive
27 Years Of Experience
Name
Unknown Individual
NPI
1053340422
Phone
Not provided
Address
2901 MONTOPOLIS DR
Deactivation Date
17 November 2022

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
8338822737
Graduation Year
1999 (27 years ago)
PAC ID
7911081955
Group Practice PAC ID
2668559436
Professional Enrollment ID
I20180613002445
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2901, Montopolis Drive, Austin, Travis County, Texas, 78741, United States

    AUSTIN, TX 787416411

    Phone:

    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 78741)

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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: 2668559436View full group profile

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1053340422 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Austin, Texas; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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