Unknown Individual – Dermatology Physician, NPI 1164515011

Unknown Individual is a healthcare provider. based in Laredo, Texas. specializing in Dermatology Physician. They hold a License No. F1663 (TX). The NPI Number for Unknown Individual is 1164515011

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164515011
Phone
(956) 726-1646
Address
121 CALLE DEL NORTE
Deactivation Date
3 January 2024

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1978 (48 years ago)
PAC ID
9234191651
Professional Enrollment ID
I20110105000157
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

  • 121, Calle del Norte, Nye, Laredo, Webb County, Texas, 78041, United States

    SUITE 102

    LAREDO, TX 780419133

    Phone: (956) 726-1646

    Fax: (956) 795-4764

    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 30 Open Payments records for all available years, with a total value of $530.

Total Amount is formed as General ($530) + Research ($0) + Ownership ($0) = $530.

Last reported payment date: 2023-10-17 • Largest payer in this snapshot: Janssen Biotech, Inc. ($225).

Total Amount

$530

General + Research + Ownership

Payments

30

Total payment records

General Amount

$530

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-17

Latest reported date

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes441312$0
17003Destruction of precancer skin growth, 2-14 growths32684$0
99212Established patient office or other outpatient visit, 10-19 minutes270219$0
17000Destruction of precancer skin growth, 1 growth169135$0
17110Destruction of skin growth, 1-14 growths113106$0
View full utilization report →

Insurance plans in this area (ZIP 78041)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1164515011 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where in Texas is Unknown Individual registered?
Use Laredo, Texas as the headline location for Unknown Individual here.
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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