Unknown Individual – Family Medicine Physician, NPI 1578827994

Unknown Individual is a healthcare provider. based in San antonio, Texas. specializing in Family Medicine Physician. They hold a License No. Q8799 (TX). The NPI Number for Unknown Individual is 1578827994

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578827994
Phone
(210) 233-7000
Address
3066 E COMMERCE ST
Deactivation Date
27 January 2021

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
2104342368
Graduation Year
2012 (14 years ago)
PAC ID
9537470075
Group Practice PAC ID
1153226691
Professional Enrollment ID
I20170113000270
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 3066 E COMMERCE ST

    SAN ANTONIO, TX 782201013

    Phone: (210) 233-7000

    Fax: (210) 434-1704

    Type: Mailing

  • 1055 Ada St

    San Antonio, TX 782231703

    Phone: (210) 358-5515

    Fax: (210) 358-5530

    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 78220)

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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 MEDICINETX93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report1212

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: 1153226691View full group profile
NameSpecialtyState
Pediatric MedicineTX
Mental Health CounselorTX
Family PracticeTX
Family PracticeTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Family PracticeTX
Family PracticeTX
O B S T E T R I C S/ G Y N E C O L O G YTX

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1578827994.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to San Antonio, Texas in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."