Unknown Individual – Psychologist, NPI 1194952820

Unknown Individual is a healthcare provider. based in Boerne, Texas. specializing in Psychologist. They hold a License No. 37255 (TX). The NPI Number for Unknown Individual is 1194952820

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1194952820
Phone
(626) 367-7744
Address
27103 SMOKEY CHASE
Deactivation Date
30 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2012 (14 years ago)
PAC ID
2668757907
Professional Enrollment ID
I20170328002440
Data current as of
20 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

  • 27103 SMOKEY CHASE

    BOERNE, TX 780156584

    Phone: (626) 367-7744

    Type: Mailing

  • 4201 Medical Dr

    Suite 330

    San Antonio, TX 782295656

    Phone: (210) 614-4990

    Type: Location

  • 1-10, Hwangnyeong-daero 481beon-gil, Namcheon 1(il)-dong, Namcheon-dong, Suyeong-gu, Busan, 48432, South Korea

    SUITE 300

    SAN ANTONIO, TX 78257

    Phone: (210) 955-9977

    Type: Location

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 78015)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1194952820 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Boerne, Texas for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1194952820. Always confirm identity and privileges with the practice and licensing boards.

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