Unknown Individual – Adult Medicine Physician, NPI 1760419170

Unknown Individual is a healthcare provider. based in Houston, Texas. specializing in Adult Medicine Physician. They hold a License No. P1671 (TX). The NPI Number for Unknown Individual is 1760419170

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760419170
Phone
(713) 338-5519
Address
909 FROSTWOOD DR
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2812658125
Graduation Year
1992 (34 years ago)
PAC ID
8628068921
Group Practice PAC ID
9537458310
Professional Enrollment ID
I20120322000279
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 909, Frostwood Drive, Memorial Hollow, Houston, Harris County, Texas, 77024, United States

    SUITE 1.100

    HOUSTON, TX 770242301

    Phone: (713) 338-5519

    Fax: (713) 704-3086

    Type: Mailing

  • Washington Avenue, Houston, Harris County, Texas, 77007, United States

    SUITE 300

    HOUSTON, TX 770075476

    Phone: (713) 861-6490

    Fax: (832) 658-5415

    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 77024)

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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: 9537458310View full group profile

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1760419170.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Adult Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Houston, Texas for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1760419170. Always confirm identity and privileges with the practice and licensing boards.

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