Unknown Individual – Gastroenterology Physician, NPI 1063478725

Unknown Individual is a healthcare provider. based in Spring, Texas. specializing in Gastroenterology Physician. They hold a License No. E1185 (TX). The NPI Number for Unknown Individual is 1063478725

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063478725
Phone
(281) 440-3618
Address
2255 E MOSSY OAKS RD
Deactivation Date
25 December 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
2814403618
Graduation Year
1973 (53 years ago)
PAC ID
2860597481
Group Practice PAC ID
3375531379
Professional Enrollment ID
I20140506000345
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

  • 2255, East Mossy Oaks Road, Springwood, Spring, Harris County, Texas, 77389, United States

    STE. 480

    SPRING, TX 773891768

    Phone: (281) 440-3618

    Fax: (281) 440-6573

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $28.

Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.

Last reported payment date: 2024-08-27 • Largest payer in this snapshot: Mallinckrodt Hospital Products Inc. ($28).

Total Amount

$28

General + Research + Ownership

Payments

1

Total payment records

General Amount

$28

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-27

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77389)

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Provider's Procedures

Unknown Individual performs procedures in Gastroenterology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GASTROENTEROLOGYTX45378Diagnostic examination of large bowel using an endoscope2020
GASTROENTEROLOGYTX45385Removal of polyps or growths of large bowel using an endoscope2626

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: 3375531379View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineTX
Nurse PractitionerTX
Internal Medicine, GastroenterologyTX
G A S T R O E N T E R O L O G YTX
Gastroenterology, Internal MedicineTX
Nurse PractitionerTX
G A S T R O E N T E R O L O G YTX
G A S T R O E N T E R O L O G YTX
Physician AssistantTX
G A S T R O E N T E R O L O G YLA

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1063478725; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Spring, Texas for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1063478725. Always confirm identity and privileges with the practice and licensing boards.

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