Unknown Individual – Pediatric Emergency Medicine (Pediatrics) Physician, NPI 1295796407

Pediatric Emergency Medicine (Pediatrics) Physician

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Pediatric Emergency Medicine (Pediatrics) Physician. They hold a License No. J6578 (TX). The NPI Number for Unknown Individual is 1295796407

Main info

Organization

Inactive

33 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1295796407

Phone

(214) 730-5437

Address

PO BOX 845347

Deactivation Date

27 February 2025

Doctor Profile

Medical School Name

UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO

Secondary Phone

2104509000

Graduation Year

1993 (33 years ago)

PAC ID

4981779931

Group Practice PAC ID

0042128548

Professional Enrollment ID

I20080826000594

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 752845347
Phone: (214) 730-5437
Type: Mailing
University of Texas Southwestern Medical Center, 5323, Harry Hines Boulevard, Dallas, TX, Dallas, Dallas County, Texas, 75390, United States
DALLAS, TX 753907208
Phone: (214) 730-5437
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 75284)

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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: 0042128548View full group profile

Name	Specialty	State
NNENNA AWAGU (CRNA)	-	TX
ELIZABETH A HALLMAN (ACNP-BC)	-	TX
EDWARD J ZAYAC (O.D.)	-	TX
ROBERT RICHARD LEVERENCE (MD)	Internal Medicine, Hospitalist	TX
JAMES PAINE (M.D.)	-	TX
Unknown Individual	-	TX
DR. MATTHEW JAMES BUTLER (M.D.)	Internal Medicine, Hematology/Oncology	TX
MOHIUDDIN RASEL	-	TX
DR. ANAND B KARNAD (M.D.)	Hematology/Oncology, Medical Oncology	TX
DR. KAREN C. DIAZ (MD)	-	TX

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?

For Unknown Individual, use NPI 1295796407 as the unique 10-digit identifier.

Can Unknown Individual still bill if the NPI is inactive?

Do not rely on inactive status alone — contact the provider for confirmation.

What clinical focus is listed for Unknown Individual?

At a glance, Unknown Individual is tied to Pediatric Emergency Medicine (Pediatrics) Physician. Clinical services aligned with this taxonomy classification.

Is Unknown Individual located near Dallas?

Unknown Individual currently maps to Dallas, Texas in this extract.

Does inactive status remove historical data?

Historical rows can remain visible after status changes — read the dates carefully.