Unknown Individual – Podiatrist, NPI 1629076773

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Podiatrist. They hold a License No. 348 (TX). The NPI Number for Unknown Individual is 1629076773

Main info

Organization
Inactive
66 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629076773
Phone
(469) 374-0555
Address
5925 FOREST LN
Deactivation Date
2 November 2022

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4693740555
Graduation Year
1960 (66 years ago)
PAC ID
9739084161
Professional Enrollment ID
I20031203000011
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

  • Preston Forest Tower, 5925, Forest Lane, Dallas, Dallas County, Texas, 75243, United States

    SUITE 516

    DALLAS, TX 752302712

    Phone: (469) 374-0555

    Fax: (469) 374-0077

    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)

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 75230)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1629076773.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Podiatrist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Dallas, Texas.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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