Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1548260607

Unknown Individual is a healthcare provider. based in Tyler, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 28463 (TX). The NPI Number for Unknown Individual is 1548260607

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1548260607
Phone
(903) 595-4144
Address
PO BOX 130639
Deactivation Date
8 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9035615018
Graduation Year
1977 (49 years ago)
PAC ID
7012939002
Group Practice PAC ID
9234025636
Professional Enrollment ID
I20051219000552
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

  • PO BOX 130639

    TYLER, TX 757130639

    Phone: (903) 595-4144

    Fax: (903) 596-7541

    Type: Mailing

  • 1424, East Front Street, Tyler, Smith County, Texas, 75702, United States

    TYLER, TX 757028501

    Phone: (903) 595-4144

    Fax: (903) 596-7541

    Type: Location

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 75713)

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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: 9234025636View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)TX
Family PracticeTX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Emergency MedicineTX
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1548260607 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Tyler?
Public fields place Unknown Individual around Tyler, Texas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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