Unknown Individual – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1508838814

Unknown Individual is a healthcare provider. based in Borger, Texas. specializing in Sports Medicine (Orthopaedic Surgery) Physician. They hold a License No. F1728 (TX). The NPI Number for Unknown Individual is 1508838814

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508838814
Phone
(806) 467-5894
Address
50 MEDICAL DRIVE
Deactivation Date
17 July 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
8064675350
Graduation Year
1978 (48 years ago)
PAC ID
7618915802
Group Practice PAC ID
0042303232
Professional Enrollment ID
I20050419000653
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

Provider Addresses for Unknown Individual

  • 50 MEDICAL DRIVE

    STE 300

    BORGER, TX 790077579

    Phone: (806) 467-5894

    Fax: (806) 274-9520

    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 79007)

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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: 0042303232View full group profile
NameSpecialtyState
Nurse PractitionerTX
General SurgeryTX
Nurse PractitionerTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX
Nurse PractitionerTX
Physician AssistantTX
Family PracticeTX
-TX
-TX

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1508838814.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Sports Medicine (Orthopaedic Surgery) Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Texas?
You will see Borger, Texas on file for Unknown Individual alongside any extra practice locations.
What if Borger, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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