Unknown Individual – Surgical Physician Assistant, NPI 1548370901

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Surgical Physician Assistant. They hold a License No. PA04721 (TX). The NPI Number for Unknown Individual is 1548370901

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1548370901
Phone
(469) 200-2832
Address
19200 PRESTON RD STE 120
Deactivation Date
15 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9724875000
Graduation Year
2005 (21 years ago)
PAC ID
3476555095
Group Practice PAC ID
2163711177
Professional Enrollment ID
I20070212000411
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

  • Preston Road, Dallas, Dallas County, Texas, 75248, United States

    DALLAS, TX 752522450

    Phone: (469) 200-2832

    Fax: (469) 269-1074

    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 $340.

Total Amount is formed as General ($340) + Research ($0) + Ownership ($0) = $340.

Last reported payment date: 2023-09-20 • Largest payer in this snapshot: Actelion Pharmaceuticals US, Inc. ($125).

Total Amount

$340

General + Research + Ownership

Payments

3

Total payment records

General Amount

$340

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-20

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 75252)

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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: 2163711177View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1548370901 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Surgical Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Dallas, Texas because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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