Unknown Individual – Cardiovascular Disease Physician, NPI 1699774117

Unknown Individual is a healthcare provider. based in Lake jackson, Texas. specializing in Cardiovascular Disease Physician. They hold a License No. H7694 (TX). The NPI Number for Unknown Individual is 1699774117

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1699774117
Phone
(979) 297-5481
Address
215 OAK DR S
Deactivation Date
6 October 2023

Doctor Profile

Medical School Name
VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Secondary Phone
9792975481
Graduation Year
1986 (40 years ago)
PAC ID
3678755774
Group Practice PAC ID
4082677513
Professional Enrollment ID
I20110310000700
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 215, Oak Drive South, Lake Jackson, Brazoria County, Texas, 77566, United States

    SUITE L

    LAKE JACKSON, TX 775665629

    Phone: (979) 297-5481

    Fax: (979) 297-1924

    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)

CMS reports 5 Open Payments records for all available years, with a total value of $66.

Total Amount is formed as General ($66) + Research ($0) + Ownership ($0) = $66.

Last reported payment date: 2023-07-27 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($52).

Total Amount

$66

General + Research + Ownership

Payments

5

Total payment records

General Amount

$66

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J2785Injection, regadenoson, 0.1 mg12832$0
99214Established patient office or other outpatient visit, 30-39 minutes118112$0
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function7877$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report7068$0
93880Ultrasound of both sides of head and neck blood flow5454$0
View full utilization report →

Insurance plans in this area (ZIP 77566)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)TX93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart4948
CARDIOVASCULAR DISEASE (CARDIOLOGY)TX93922Ultrasound study of arteries of both arms and legs1816

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: 4082677513View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineTX

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1699774117; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Lake Jackson, Texas for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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