Unknown Individual – Specialist, NPI 1629059498

Unknown Individual is a healthcare provider. based in Bedford, Texas. specializing in Specialist. They hold a License No. F5704 (TX). The NPI Number for Unknown Individual is 1629059498

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629059498
Phone
(817) 540-3121
Address
1615 HOSPITAL PKWY
Deactivation Date
29 March 2023

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
8175403121
Graduation Year
1979 (47 years ago)
PAC ID
6002983319
Group Practice PAC ID
9133150691
Professional Enrollment ID
I20100812000295
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

  • 1615, Hospital Parkway, Bedford, Tarrant County, Texas, 76022, United States

    STE. 210

    BEDFORD, TX 760225934

    Phone: (817) 540-3121

    Fax: (817) 355-4511

    Type: Location

  • 601 GREEN MEADOW ST N

    COLLEYVILLE, TX 760343916

    Phone: (817) 498-6299

    Fax: (817) 355-4511

    Type: Mailing

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 76022)

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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: 9133150691View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YTX
O T O L A R Y N G O L O G YTX
-TX
O T O L A R Y N G O L O G YTX
Otolaryngology, Plastic And Reconstructive SurgeryTX
Qualified AudiologistTX
O T O L A R Y N G O L O G YTX
O T O L A R Y N G O L O G YTX
-TX
Physician AssistantTX

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1629059498 in the public NPI dataset.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Other Service Providers. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Bedford, Texas may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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