Unknown Individual – Internal Medicine Physician, NPI 1386782266

Unknown Individual is a healthcare provider. based in Odessa, Texas. specializing in Internal Medicine Physician. They hold a License No. D0770 (TX). The NPI Number for Unknown Individual is 1386782266

Main info

Organization
Inactive
63 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1386782266
Phone
(432) 580-9444
Address
500 N WASHINGTON AVE STE 100
Deactivation Date
27 March 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
-
Graduation Year
1963 (63 years ago)
PAC ID
3476685769
Professional Enrollment ID
I20100722000350
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 100, North Washington Avenue, Industrial, Odessa, Ector County, Texas, 79761, United States

    ODESSA, TX 797614441

    Phone: (432) 580-9444

    Fax: (432) 580-9555

    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 2 Open Payments records for all available years, with a total value of $49.

Total Amount is formed as General ($49) + Research ($0) + Ownership ($0) = $49.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Boston Scientific Corporation ($49).

Total Amount

$49

General + Research + Ownership

Payments

2

Total payment records

General Amount

$49

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

Top Companies

Largest payers in this snapshot

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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 79761)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1386782266 in the public NPI dataset.
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 Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Odessa, Texas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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