Unknown Individual – Nurse Practitioner, NPI 1316048994

Unknown Individual is a healthcare provider. based in Canton, Texas. specializing in Nurse Practitioner. They hold a License No. 607227 (TX). The NPI Number for Unknown Individual is 1316048994

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1316048994
Phone
(903) 567-4841
Address
18780 INTERSTATE 20
Deactivation Date
31 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9037290970
Graduation Year
1998 (28 years ago)
PAC ID
8426271784
Group Practice PAC ID
0345272381
Professional Enrollment ID
I20140514001762
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

Provider Addresses for Unknown Individual

  • 18780 INTERSTATE 20

    CANTON, TX 751033593

    Phone: (903) 567-4841

    Type: Location

  • Band Box Place, Dallas, Dallas County, Texas, 75244, United States

    DALLAS, TX 752846098

    Phone: (903) 324-6450

    Type: Mailing

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 75103)

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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: 0345272381View full group profile
NameSpecialtyState
Nurse PractitionerTX
-TX
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX
Nurse PractitionerTX
-UT
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1316048994 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Canton, Texas may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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