Unknown Individual – Family Medicine Physician, NPI 1366732042

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Family Medicine Physician. They hold a License No. BP10039513 (TX). The NPI Number for Unknown Individual is 1366732042

Main info

Organization
Inactive
15 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366732042
Phone
(214) 947-5400
Address
3500 W WHEATLAND RD
Deactivation Date
1 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2145208833
Graduation Year
2011 (15 years ago)
PAC ID
5092942904
Group Practice PAC ID
7416196092
Professional Enrollment ID
I20140707000403
Data current as of
20 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

  • 3500 W WHEATLAND RD

    DALLAS, TX 752373460

    Phone: (214) 947-5400

    Fax: (214) 947-5476

    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)

CMS reports 156 Open Payments records for all available years, with a total value of $2,781.

Total Amount is formed as General ($2,781) + Research ($0) + Ownership ($0) = $2,781.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ViiV Healthcare Company ($653).

Total Amount

$2,781

General + Research + Ownership

Payments

156

Total payment records

General Amount

$2,781

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes8745$0
99213Established patient office or other outpatient visit, 20-29 minutes6647$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit4040$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report2422$0
View full utilization report →

Insurance plans in this area (ZIP 75237)

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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: 7416196092View full group profile
NameSpecialtyState
Internal Medicine, Infectious DiseaseTX
Nurse PractitionerTX
Internal MedicineTX
Infectious Disease, Internal MedicineTX

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1366732042.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Texas is Unknown Individual registered?
Use Dallas, Texas as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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