Unknown Individual – Anesthesiologist Assistant, NPI 1730679291

Anesthesiologist Assistant

Unknown Individual is a healthcare provider. based in Kingwood, Texas. specializing in Anesthesiologist Assistant. They hold a License No. 24570612 (TX). The NPI Number for Unknown Individual is 1730679291

Main info

Organization

Inactive

8 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1730679291

Phone

(281) 348-8245

Address

22999 Highway 59 N

Deactivation Date

3 August 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2813488245

Graduation Year

2018 (8 years ago)

PAC ID

5092064790

Group Practice PAC ID

7315850351

Professional Enrollment ID

I20180814000121

Data current as of

20 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

22999 Highway 59 N
Kingwood, TX 773394412
Phone: (281) 348-8245
Fax: (281) 348-8250
Type: Location
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 752650865
Phone: (972) 233-1999
Fax: (972) 233-3666
Type: Mailing
Citywest Boulevard, Houston, Harris County, Texas, 77042-9998, United States
HOUSTON, TX 770422549
Phone: (713) 620-4000
Fax: (713) 458-4229
Type: Location
1500 Citywest Blvd Ste 300
Houston, TX 770422549
Phone: (713) 620-4000
Fax: (713) 458-4229
Type: Location

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.

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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 77339)

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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: 7315850351View full group profile

Name	Specialty	State
EDITHA A FLEMMING (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
MR. JOHN PAUL SCHREINER (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
DR. ELVIS TSANG (MD)	A N E S T H E S I O L O G Y	TX
ADAM PEEPLES (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
ALYSSA ESTILL (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
LAUREN CARTER SEGERSON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
MICHAEL D HENDERSON (MD)	-	TX
DR. MAHEEN ADAM WARDAK (MD)	-	TX
DR. KAPIL KASHYAP (M.D.)	-	TX
DR. KEITH NEAL SUMNER (M.D.)	A N E S T H E S I O L O G Y	TX