Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1124071295

Unknown Individual is a healthcare provider. based in Winnsboro, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 736281 (TX). The NPI Number for Unknown Individual is 1124071295

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124071295
Phone
(903) 707-4768
Address
719 W COKE RD
Deactivation Date
7 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9037636220
Graduation Year
1985 (41 years ago)
PAC ID
7911819081
Group Practice PAC ID
9133484330
Professional Enrollment ID
I20101008000951
Data current as of
3 June 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

  • CHRISTUS Mother Frances Hospital - Winnsboro, 719, West Coke Road, Winnsboro, Wood County, Texas, 75494, United States

    WINNSBORO, TX 754943011

    Phone: (903) 707-4768

    Type: Location

  • 4560, Farm-to-Market Road 312, Winnsboro, Wood County, Texas, 75494, United States

    WINNSBORO, TX 754948056

    Phone: (903) 707-4768

    Type: Mailing

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 75494)

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Provider's Procedures

Unknown Individual performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHETTX00790Anesthesia for procedure in upper abdomen including use of an endoscope1515

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: 9133484330View full group profile
NameSpecialtyState
Nurse PractitionerTX
Family PracticeTX
Certified Registered Nurse Anesthetist (Crna)TX
-AR
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Family Practice, Obstetrics/GynecologyTX

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1124071295.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Winnsboro, Texas for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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