Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1336103068

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R156916 (MD). The NPI Number for Unknown Individual is 1336103068

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336103068
Phone
(410) 247-7500
Address
PO BOX 841726
Deactivation Date
29 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4109929797
Graduation Year
1988 (38 years ago)
PAC ID
0941385173
Group Practice PAC ID
1951734078
Professional Enrollment ID
I20080324000496
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 841726

    DALLAS, TX 752841726

    Phone: (410) 247-7500

    Fax: (410) 247-4227

    Type: Mailing

  • 700, Geipe Road, Catonsville, Baltimore County, Maryland, 21228, United States

    SUITE 230

    CATONSVILLE, MD 21228

    Phone: (410) 247-7500

    Fax: (410) 247-4227

    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: 1951734078View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)NY
Certified Registered Nurse Anesthetist (Crna)VA
-MD
Physician AssistantMD
A N E S T H E S I O L O G YTX
Certified Registered Nurse Anesthetist (Crna)MD
Certified Registered Nurse Anesthetist (Crna)MD
-MD
Certified Registered Nurse Anesthetist (Crna)MD
-MD

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1336103068 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
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 Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Dallas, Texas in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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