Unknown Individual – Ophthalmology Physician, NPI 1629187471

Ophthalmology Physician

Unknown Individual is a healthcare provider. based in Laredo, Texas. specializing in Ophthalmology Physician. They hold a License No. D7341 (TX). The NPI Number for Unknown Individual is 1629187471

Main info

Organization

Inactive

56 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1629187471

Phone

(956) 724-7179

Address

1006 HILLSIDE

Deactivation Date

1 March 2023

Doctor Profile

Medical School Name

UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON

Secondary Phone

9567247179

Graduation Year

1970 (56 years ago)

PAC ID

1951465582

Group Practice PAC ID

4587728118

Professional Enrollment ID

I20090127000357

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

1006, East Hillside Road, Nye, Laredo, Webb County, Texas, 78041, United States
STE 1
LAREDO, TX 780413287
Phone: (956) 724-7179
Fax: (956) 725-2402
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.

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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 78041)

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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: 4587728118View full group profile