Unknown Individual – Family Medicine Physician, NPI 1174541569

Unknown Individual is a healthcare provider. based in Rio grande city, Texas. specializing in Family Medicine Physician. They hold a License No. E0238 (TX). The NPI Number for Unknown Individual is 1174541569

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174541569
Phone
(956) 487-5621
Address
2768 PHARMACY RD
Deactivation Date
12 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9564875621
Graduation Year
2001 (25 years ago)
PAC ID
8123022365
Group Practice PAC ID
3476522012
Professional Enrollment ID
I20060831000170
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 2768 PHARMACY RD

    RIO GRANDE CITY, TX 785826201

    Phone: (956) 487-5621

    Fax: (956) 487-5862

    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 5 Open Payments records for all available years, with a total value of $96.

Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Lilly USA, LLC ($31).

Total Amount

$96

General + Research + Ownership

Payments

5

Total payment records

General Amount

$96

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

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 78582)

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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: 3476522012View full group profile
NameSpecialtyState
General PracticeTX
Family Practice, Emergency MedicineTX
Family PracticeTX
Physician AssistantTX
Family PracticeTX
Physician AssistantTX
Physician AssistantTX

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1174541569.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Rio Grande City, Texas as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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