Unknown Individual – Family Medicine Physician, NPI 1396716957

Unknown Individual is a healthcare provider. based in Kerrville, Texas. specializing in Family Medicine Physician. They hold a License No. M0030 (TX). The NPI Number for Unknown Individual is 1396716957

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396716957
Phone
(830) 896-4711
Address
220 WESLEY DR
Deactivation Date
3 November 2021

Doctor Profile

Medical School Name
TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
Secondary Phone
8308964711
Graduation Year
2002 (24 years ago)
PAC ID
8527091982
Group Practice PAC ID
6103818596
Professional Enrollment ID
I20050915000677
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

  • 220, Wesley Drive, Kerrville, Kerr County, Texas, 78028, United States

    KERRVILLE, TX 780285809

    Phone: (830) 896-4711

    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 3 Open Payments records for all available years, with a total value of $52.

Total Amount is formed as General ($52) + Research ($0) + Ownership ($0) = $52.

Last reported payment date: 2024-07-17 • Largest payer in this snapshot: ABBVIE INC. ($52).

Total Amount

$52

General + Research + Ownership

Payments

3

Total payment records

General Amount

$52

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$52
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78028)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINETX83036Hemoglobin A1C level316181

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: 6103818596View full group profile
NameSpecialtyState
-TX

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1396716957; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Kerrville, Texas because that is what the record indicates for Unknown Individual.
What if Kerrville, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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