Unknown Individual – Physician Assistant, NPI 1205898053

Unknown Individual is a healthcare provider. based in Corpus christi, Texas. specializing in Physician Assistant. They hold a License No. PA03546 (TX). The NPI Number for Unknown Individual is 1205898053

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205898053
Phone
(361) 882-4452
Address
5734 SPOHN DR
Deactivation Date
12 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3612410324
Graduation Year
2002 (24 years ago)
PAC ID
1052349347
Group Practice PAC ID
9638460330
Professional Enrollment ID
I20050728000474
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

  • 5734, Spohn Drive, South Side, Corpus Christi, Nueces County, Texas, 78414, United States

    CORPUS CHRISTI, TX 784144116

    Phone: (361) 882-4452

    Fax: (361) 882-5414

    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 16 Open Payments records for all available years, with a total value of $336.

Total Amount is formed as General ($336) + Research ($0) + Ownership ($0) = $336.

Last reported payment date: 2024-11-27 • Largest payer in this snapshot: Boston Scientific Corporation ($288).

Total Amount

$336

General + Research + Ownership

Payments

16

Total payment records

General Amount

$336

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-27

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 78414)

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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: 9638460330View full group profile
NameSpecialtyState
Physician AssistantTX
Nurse PractitionerTX
-TX
Nurse PractitionerTX
Pain ManagementTX
Nurse PractitionerTX
Physician AssistantTX
Anesthesiology, Pain ManagementTX
Physical Medicine And Rehabilitation, Pain ManagementTX
Physical Medicine And Rehabilitation, Pain ManagementPA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1205898053 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
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 Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Corpus Christi, Texas.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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