Unknown Individual – Surgery Physician, NPI 1780792390

Unknown Individual is a healthcare provider. based in Galveston, Texas. specializing in Surgery Physician. They hold a License No. E6456 (TX). The NPI Number for Unknown Individual is 1780792390

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1780792390
Phone
(409) 772-2222
Address
301 UNIVERSITY BLVD
Deactivation Date
23 April 2026

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
4097722222
Graduation Year
1976 (50 years ago)
PAC ID
3577560127
Group Practice PAC ID
3375456734
Professional Enrollment ID
I20061025000126
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

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Provider Addresses for Unknown Individual

  • 301, University Boulevard - 6th Street, Galveston, Galveston County, Texas, 77550, United States

    GALVESTON, TX 775555302

    Phone: (409) 772-2222

    Mailing address matches the actual address.

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 77555)

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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: 3375456734View full group profile
NameSpecialtyState
-TX
-TX
-NY
Sleep Medicine, Critical Care (Intensivists)TX
Surgical OncologyNY
General SurgeryTN
General SurgeryGA
U R O L O G YNY
Nurse PractitionerTX
O B S T E T R I C S/ G Y N E C O L O G YTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1780792390 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Galveston, Texas in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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