Unknown Individual – Urology Physician, NPI 1063472470

Unknown Individual is a healthcare provider. based in Huntsville, Texas. specializing in Urology Physician. They hold a License No. H1883 (TX). The NPI Number for Unknown Individual is 1063472470

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063472470
Phone
(281) 404-3000
Address
100 Medical Center Pkwy Ste 600
Deactivation Date
19 June 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Secondary Phone
9364359200
Graduation Year
1990 (36 years ago)
PAC ID
3577550748
Group Practice PAC ID
3173770005
Professional Enrollment ID
I20090424000039
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

  • 100 Medical Center Pkwy Ste 600

    Huntsville, TX 773404965

    Phone: (281) 404-3000

    Fax: (936) 273-6911

    Type: Location

  • 350 Kingwood Medical Dr Ste 140

    Kingwood, TX 773396406

    Phone: (281) 404-3000

    Fax: (936) 273-6911

    Type: Location

  • 135, Vision Park Boulevard, Shenandoah, Montgomery County, Texas, 77384, United States

    SHENANDOAH, TX 773843001

    Phone: (281) 404-3000

    Fax: (936) 273-6911

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 47 Open Payments records for all available years, with a total value of $1,027.

Total Amount is formed as General ($1,027) + Research ($0) + Ownership ($0) = $1,027.

Last reported payment date: 2024-03-06 • Largest payer in this snapshot: ABBVIE INC. ($181).

Total Amount

$1,027

General + Research + Ownership

Payments

47

Total payment records

General Amount

$1,027

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-06

Latest reported date

Top Companies

Largest payers in this snapshot

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
87798Detection test by nucleic acid for organism, amplified probe technique6,047309$0
87481Detection test for candida species (yeast), amplified probe technique2,323309$0
81001Manual urinalysis test with examination using microscope, automated1,581968$0
99213Established patient office or other outpatient visit, 20-29 minutes1,470815$0
J9030Bcg live intravesical instillation, 1 mg1,35013$0
View full utilization report →

Insurance plans in this area (ZIP 77340)

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Provider's Procedures

Unknown Individual performs procedures in Urology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
UROLOGYTX55700Biopsy of prostate gland2929
UROLOGYTX76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle2929

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: 3173770005View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1063472470.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Urology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Huntsville, Texas in the data we show; additional addresses may exist on the full record.
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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