Unknown Individual – Family Nurse Practitioner, NPI 1053626622

Unknown Individual is a healthcare provider. based in Midland, Texas. specializing in Family Nurse Practitioner. They hold a License No. AP119132 (TX). The NPI Number for Unknown Individual is 1053626622

Main info

Organization
Inactive
17 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053626622
Phone
(432) 571-2680
Address
4815 E Highway 80
Deactivation Date
15 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8173497541
Graduation Year
2009 (17 years ago)
PAC ID
3678752730
Group Practice PAC ID
0749535763
Professional Enrollment ID
I20110121000810
Data current as of
20 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

  • 4815 E Highway 80

    Midland, TX 797064475

    Phone: (432) 571-2680

    Type: Location

  • 2505 NOEL AVE

    MIDLAND, TX 797053336

    Phone: (432) 638-7311

    Type: Mailing

  • 5000 BRIARWOOD AVE STE 203

    MIDLAND, TX 79707

    Phone: (432) 687-6870

    Fax: (432) 687-5558

    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 79706)

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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: 0749535763View full group profile
NameSpecialtyState
C H I R O P R A C T I CTX
C H I R O P R A C T I CTX
Nurse PractitionerTX
C H I R O P R A C T I CTX
C H I R O P R A C T I CTX

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1053626622 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Midland, Texas for Unknown Individual based on available NPPES addresses.
What if Midland, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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