Unknown Individual – Internal Medicine Physician, NPI 1518964634

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Internal Medicine Physician. They hold a License No. J9956 (TX). The NPI Number for Unknown Individual is 1518964634

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1518964634
Phone
(817) 702-8450
Address
PO BOX 732973
Deactivation Date
10 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8177023431
Graduation Year
1985 (41 years ago)
PAC ID
7416905872
Group Practice PAC ID
4587963582
Professional Enrollment ID
I20050112000415
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

  • Band Box Place, Dallas, Dallas County, Texas, 75244, United States

    DALLAS, TX 753732973

    Phone: (817) 702-8450

    Type: Mailing

  • John Peter Smith Hospital, 1500, South Main Street, Fort Worth, Tarrant County, Texas, 76104, United States

    FORT WORTH, TX 761044917

    Phone: (817) 702-3431

    Fax: (817) 927-3603

    Type: Location

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 $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2024-02-20 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($43).

Total Amount

$43

General + Research + Ownership

Payments

2

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-20

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.

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

Insurance plans in this area (ZIP 75373)

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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: 4587963582View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1518964634.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Dallas, Texas?
If you are local to Dallas, Texas, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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