Unknown Individual – Physical Therapist, NPI 1346254018

Unknown Individual is a healthcare provider. based in Beaumont, Texas. specializing in Physical Therapist. They hold a License No. 1030567 (TX). The NPI Number for Unknown Individual is 1346254018

Main info

Organization
Inactive
45 Years Of Experience
Name
Unknown Individual
NPI
1346254018
Phone
(409) 835-0033
Address
3515 FANNIN ST
Deactivation Date
27 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4098350033
Graduation Year
1981 (45 years ago)
PAC ID
9234207309
Group Practice PAC ID
3779660840
Professional Enrollment ID
I20090114000455
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

  • 3515, Fannin Street, Beaumont, Jefferson County, Texas, 77701, United States

    SUITE 101

    BEAUMONT, TX 777013815

    Phone: (409) 835-0033

    Fax: (409) 835-0213

    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 77701)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYTX97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes295999

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1346254018.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Beaumont, Texas; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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