Unknown Individual – Family Medicine Physician, NPI 1063510493

Unknown Individual is a healthcare provider. based in Bellaire, Texas. specializing in Family Medicine Physician. They hold a License No. E5747 (TX). The NPI Number for Unknown Individual is 1063510493

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063510493
Phone
(713) 663-6322
Address
5420 BELLAIRE BLVD STE A
Deactivation Date
27 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7136636322
Graduation Year
1966 (60 years ago)
PAC ID
8123083128
Group Practice PAC ID
3476792151
Professional Enrollment ID
I20041201000168
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 5420 BELLAIRE BLVD STE A

    BELLAIRE, TX 774013957

    Phone: (713) 663-6322

    Fax: (713) 663-6944

    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 $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-08-17 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-17

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 77401)

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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: 3476792151View full group profile
NameSpecialtyState
-TX

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1063510493 for Unknown Individual.
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 Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Bellaire, 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.

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