Unknown Individual – Physician Assistant, NPI 1205138591

Unknown Individual is a healthcare provider. based in Rockwall, Texas. specializing in Physician Assistant. They hold a License No. PA06939 (TX). The NPI Number for Unknown Individual is 1205138591

Main info

Organization
Inactive
16 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205138591
Phone
(972) 772-9600
Address
3142 HORIZON RD STE 100
Deactivation Date
23 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8174429300
Graduation Year
2010 (16 years ago)
PAC ID
9830329762
Group Practice PAC ID
1951604313
Professional Enrollment ID
I20140220000601
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 3142 HORIZON RD STE 100

    ROCKWALL, TX 750327809

    Phone: (972) 772-9600

    Fax: (972) 772-9601

    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)

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 75032)

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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: 1951604313View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Orthopedic SurgeryTX
Nurse PractitionerTX
-TX
Pain Management, AnesthesiologyTX
Physical Medicine And RehabilitationTX
Physician AssistantTX
Pain Management, AnesthesiologyTX
Physical Therapist In Private PracticeTX
Physical Medicine And RehabilitationTX

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1205138591.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Rockwall, Texas?
For routing, start with Rockwall, Texas for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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