Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1154428126

Unknown Individual is a healthcare provider. based in Gonzales, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 727862 (TX). The NPI Number for Unknown Individual is 1154428126

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154428126
Phone
(830) 672-7581
Address
1110 N SARAH DEWITT DR
Deactivation Date
15 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8173373671
Graduation Year
1986 (40 years ago)
PAC ID
5092613679
Group Practice PAC ID
4789845363
Professional Enrollment ID
I20050729000795
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

  • Gonzales Healthcare Systems, 1110, North Sarah Dewitt Drive, Gonzales, Gonzales County, Texas, 78629, United States

    GONZALES, TX 786293311

    Phone: (830) 672-7581

    Fax: (830) 672-8481

    Type: Location

  • 1212, Jerad Street, Bentwood, New Braunfels, Guadalupe County, Texas, 78130, United States

    NEW BRAUNFELS, TX 781303422

    Phone: (979) 733-7408

    Fax: (830) 672-8481

    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.

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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.

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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 78629)

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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: 4789845363View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)HI
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1154428126.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Gonzales, Texas for Unknown Individual; expand the address list for detail.
What if Gonzales, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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