Unknown Individual – Geriatric Medicine (Internal Medicine) Physician, NPI 1073602447

Geriatric Medicine (Internal Medicine) Physician

Unknown Individual is a healthcare provider. based in Houston, Texas. specializing in Geriatric Medicine (Internal Medicine) Physician. They hold a License No. H5750 (TX). The NPI Number for Unknown Individual is 1073602447

Main info

Organization

Inactive

38 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1073602447

Phone

(713) 873-4895

Address

3601 N MACGREGOR WAY

Deactivation Date

29 June 2021

Doctor Profile

Medical School Name

BAYLOR COLLEGE OF MEDICINE

Secondary Phone

7135005736

Graduation Year

1988 (38 years ago)

PAC ID

0244232858

Group Practice PAC ID

2567544570

Professional Enrollment ID

I20070212000261

Contacts

Secure Messaging

carmeldyer@direct.utphysicians.net

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness85

Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

Quentin Mease Hospital, 3601, North MacGregor Way, Houston, Harris County, Texas, 77004, United States
HOUSTON, TX 770048004
Phone: (713) 873-4895
Fax: (713) 873-4896
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 77004)

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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: 2567544570View full group profile

Name	Specialty	State
DR. GABRIEL MARCELO AISENBERG (M.D.)	Internal Medicine	TX
ELIANA ALONZO (FNP-C)	Nurse Practitioner	TX
OLASUNKANMI ADEYINKA (M.D.)	Hospitalist, Family Practice	TX
DR. FAITH DATA ATAI (M.D)	Geriatric Medicine, Family Practice, Internal Medicine	TX
ROBBY G WESLEY (DO)	Internal Medicine	TX
BAL REDDY (M.D.)	Family Practice	TX
AMINA ZUBAIR (M.D.)	-	TX
PHILIP C III JOHNSON (M.D.)	Internal Medicine, Infectious Disease	TX
DR. NAHID JAMAL RIANON (M.D.)	Geriatric Medicine, Family Practice	TX
ROBERT S TAN (M.D.)	-	TX

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?

Unknown Individual's NPI is 1073602447 — the number used across U.S. healthcare to identify this provider.

Is inactive the same as retired for Unknown Individual?

Inactive registry status can reflect deactivation, consolidation, or data lag.

What area of care is associated with Unknown Individual?

Unknown Individual's record emphasizes Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.

Is Unknown Individual located near Houston?

Unknown Individual currently maps to Houston, Texas in this extract.

When was this NPI issued?

Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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