Unknown Individual – Internal Medicine Physician, NPI 1740255587

Unknown Individual is a healthcare provider. based in Corsicana, Texas. specializing in Internal Medicine Physician. They hold a License No. E3602 (TX). The NPI Number for Unknown Individual is 1740255587

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740255587
Phone
(903) 872-3005
Address
401 HOSPITAL DR
Deactivation Date
4 March 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
9036544604
Graduation Year
1971 (55 years ago)
PAC ID
8921082173
Group Practice PAC ID
7113015793
Professional Enrollment ID
I20081113000196
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

  • Hospital Drive, Corsicana, Navarro County, Texas, 75110, United States

    SUITE 120

    CORSICANA, TX 751102415

    Phone: (903) 872-3005

    Fax: (903) 872-3050

    Type: Mailing

  • 301, Hospital Drive, Corsicana, Navarro County, Texas, 75110, United States

    SUITE 195

    CORSICANA, TX 751102471

    Phone: (903) 872-3005

    Fax: (903) 874-5198

    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.

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 75110)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINETX85610Blood test, clotting time14119
INTERNAL MEDICINETX90670Pneumococcal vaccine for injection into muscle2323

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: 7113015793View full group profile
NameSpecialtyState
-TX

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1740255587 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Corsicana?
Unknown Individual currently maps to Corsicana, Texas in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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