Unknown Individual – Family Nurse Practitioner, NPI 1639162761

Unknown Individual is a healthcare provider. based in Linden, Texas. specializing in Family Nurse Practitioner. They hold a License No. AP100079 (TX). The NPI Number for Unknown Individual is 1639162761

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639162761
Phone
(903) 756-5581
Address
402 N KAUFMAN ST
Deactivation Date
7 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9037565581
Graduation Year
1979 (47 years ago)
PAC ID
4880882430
Group Practice PAC ID
8527038298
Professional Enrollment ID
I20101222001043
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

Provider Addresses for Unknown Individual

  • 402 N KAUFMAN ST

    LINDEN, TX 755635234

    Phone: (903) 756-5581

    Fax: (903) 756-5005

    Type: Location

  • 4002, Technology Center, Lost Creek Business Park, Longview, Gregg County, Texas, 75605, United States

    LONGVIEW, TX 756052697

    Phone: (903) 247-0484

    Fax: (903) 247-0485

    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 75563)

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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: 8527038298View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
-TX
-TX
Nurse PractitionerTX
Nurse PractitionerTX
Family PracticeTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1639162761; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Texas?
You will see Linden, Texas on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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