Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1215998307

Anatomic Pathology & Clinical Pathology Physician

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. F4223 (TX). The NPI Number for Unknown Individual is 1215998307

Main info

Organization

Inactive

53 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1215998307

Phone

(915) 577-7316

Address

PO BOX 744127

Deactivation Date

28 September 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9155776011

Graduation Year

1973 (53 years ago)

PAC ID

6103832613

Group Practice PAC ID

6002870532

Professional Enrollment ID

I20060221000603

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

Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 75374
Phone: (915) 577-7316
Fax: (915) 577-7345
Type: Mailing
Providence Memorial Hospital, 2001, North Oregon Street, El Paso, El Paso County, Texas, 79902, United States
EL PASO, TX 79902
Phone: (915) 577-6011
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.

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 75374)

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Provider's Procedures

Unknown Individual performs procedures in Anatomic Pathology & Clinical Pathology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PATHOLOGY	TX	88312	Special stained specimen slides to identify organisms including interpretation and report	58	23

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: 6002870532View full group profile

Name	Specialty	State
Unknown Individual	-	TX
DR. FAUSTO A RODRIGUEZ (M.D.)	-	TX
DR. KHALED SARAH (M.D.)	-	TX
OCTAVIO TREJO (MD)	-	TX
ARTURO LEVARO VARGAS (MD)	-	TX

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 1215998307.

Is Unknown Individual excluded from programs when inactive?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What is Unknown Individual's specialty?

The listing groups Unknown Individual with Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Dallas, Texas may find Unknown Individual in results; validate coverage separately.

How many locations tie to this NPI?

2 practice locations appear in the available data.