Unknown Individual – Vascular Surgery Physician, NPI 1760574354

Unknown Individual is a healthcare provider. based in Kerrville, Texas. specializing in Vascular Surgery Physician. They hold a License No. E1163 (TX). The NPI Number for Unknown Individual is 1760574354

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760574354
Phone
(830) 997-7138
Address
1331 BANDERA HWY STE 1
Deactivation Date
18 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8309901404
Graduation Year
1973 (53 years ago)
PAC ID
5294801585
Group Practice PAC ID
7517141997
Professional Enrollment ID
I20080910000674
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

Provider Addresses for Unknown Individual

  • 1331 BANDERA HWY STE 1

    KERRVILLE, TX 780289535

    Phone: (830) 997-7138

    Fax: (830) 997-8678

    Type: Location

  • 130, West Windcrest Street, Fredericksburg, Gillespie County, Texas, 78624, United States

    FREDERICKSBURG, TX 786244478

    Phone: (830) 990-1404

    Type: Mailing

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 78028)

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Provider's Procedures

Unknown Individual performs procedures in Vascular Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
VASCULAR SURGERYTX93922Ultrasound study of arteries of both arms and legs6156

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: 7517141997View full group profile
NameSpecialtyState
Nurse PractitionerTX
-TX
-TX
Physician AssistantTX
-TX
Pulmonary Disease, Critical Care (Intensivists), Internal Medicine, Sleep MedicineTX
-TX
-TX
Internal MedicineTX
N E U R O L O G YTX

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1760574354 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Vascular Surgery Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Kerrville?
Unknown Individual currently maps to Kerrville, Texas in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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