Unknown Individual – Psychiatry Physician, NPI 1235147455

Unknown Individual is a healthcare provider. based in Waco, Texas. specializing in Psychiatry Physician. They hold a License No. H7904 (TX). The NPI Number for Unknown Individual is 1235147455

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1235147455
Phone
(254) 751-4880
Address
PO BOX 20308
Deactivation Date
17 November 2022

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
2547765970
Graduation Year
1989 (37 years ago)
PAC ID
7012990682
Group Practice PAC ID
6305731068
Professional Enrollment ID
I20040612000666
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

  • PO BOX 20308

    WACO, TX 767020308

    Phone: (254) 751-4880

    Fax: (254) 751-4885

    Type: Mailing

  • DePaul Center, 301, Londonderry Drive, Waco, McLennan County, Texas, 76712, United States

    WACO, TX 767127915

    Phone: (254) 751-4880

    Fax: (254) 751-4885

    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 76702)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYTX90792Psychiatric diagnostic evaluation with medical services4444

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: 6305731068View full group profile
NameSpecialtyState
P O D I A T R YTX
U R O L O G YTX
Physician AssistantAZ
Nurse PractitionerTX
-TX
O B S T E T R I C S/ G Y N E C O L O G YTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Family PracticeTX
General SurgeryTX
Internal MedicineTX

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1235147455 uniquely identifies Unknown Individual in U.S. healthcare data.
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 Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Waco, Texas in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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