Unknown Individual – Diagnostic Radiology Physician, NPI 1306849450

Unknown Individual is a healthcare provider. based in Athens, Texas. specializing in Diagnostic Radiology Physician. They hold a License No. E5444 (TX). The NPI Number for Unknown Individual is 1306849450

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306849450
Phone
(903) 675-6778
Address
810 LUCAS DR
Deactivation Date
3 March 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
9036756778
Graduation Year
1973 (53 years ago)
PAC ID
0042254534
Group Practice PAC ID
3971591223
Professional Enrollment ID
I20070224000195
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

  • Lucas Drive, Athens, Henderson County, Texas, 75751, United States of America

    ATHENS, TX 757513446

    Phone: (903) 675-6778

    Fax: (903) 675-2333

    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 75751)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYTX73110X-ray of wrist, minimum of 3 views3532
DIAGNOSTIC RADIOLOGYTX73140X-ray of fingers, minimum of 2 views1716
DIAGNOSTIC RADIOLOGYTX73630X-ray of foot, minimum of 3 views9688
DIAGNOSTIC RADIOLOGYTX78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies3232
DIAGNOSTIC RADIOLOGYTX93922Ultrasound study of arteries of both arms and legs1613

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: 3971591223View full group profile
NameSpecialtyState
-TX

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1306849450.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Diagnostic Radiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Athens, Texas because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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