Unknown Individual – Adult Medicine Physician, NPI 1720040751

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Adult Medicine Physician. They hold a License No. K6315 (TX). The NPI Number for Unknown Individual is 1720040751

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1720040751
Phone
(214) 648-8259
Address
PO BOX 845347
Deactivation Date
1 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2146453900
Graduation Year
1990 (36 years ago)
PAC ID
0840249173
Group Practice PAC ID
0648188250
Professional Enrollment ID
I20050113000682
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

Loading map...

Provider Addresses for Unknown Individual

  • Band Box Place, Dallas, Dallas County, Texas, 75244, United States

    DALLAS, TX 752845347

    Phone: (214) 648-8259

    Type: Mailing

  • University of Texas Southwestern Medical Center, 5323, Harry Hines Boulevard, Dallas, TX, Dallas, Dallas County, Texas, 75390, United States

    DALLAS, TX 753907208

    Phone: (214) 648-8259

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes6654$0
99214Established patient office or other outpatient visit, 30-39 minutes6452$0
99215Established patient office or other outpatient visit, 40-54 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 75284)

Loading plans...

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: 0648188250View full group profile
NameSpecialtyState
-TX
Diagnostic RadiologyTX
Anesthesiology, Pain ManagementFL
-TX
Internal MedicineTX
-TX
U R O L O G YTX
-TX
-TX
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1720040751 in the public NPI dataset.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Adult Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Dallas, Texas; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

Similar Providers

DAN SEPDHAM (M.D.)

Adult Medicine Physician
5909, Harry Hines Boulevard, Dallas, Dallas County, Texas, 75390, United States
NPI: 1831186543

DAVID A SLATER (MD)

Adult Medicine Physician
1395 E ELDORADO PKWY STE 400
NPI: 1477526994

STEVEN J COHEN (MD)

Rheumatology Physician
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
NPI: 1063485886

DR. TAMARA LYNNE MCGREGOR (MD)

Adult Medicine Physician
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
NPI: 1194785097

LUIS PALACIOS (MD)

Adult Medicine Physician
6333 E Mockingbird Ln
NPI: 1487614392

THOMAS ALEXANDER KING (MD)

Family Medicine Physician
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
NPI: 1104886019

SHELLEY POE JR. ROATEN (MD)

Adult Medicine Physician
University of Texas Southwestern Medical Center, 5323, Harry Hines Boulevard, Dallas, TX, Dallas, Dallas County, Texas, 75390, United States
NPI: 1336101377