Unknown Individual – Family Medicine Physician, NPI 1801890827

Unknown Individual is a healthcare provider. based in La grange, Texas. specializing in Family Medicine Physician. They hold a License No. J1933 (TX). The NPI Number for Unknown Individual is 1801890827

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1801890827
Phone
(979) 968-3800
Address
890 E TRAVIS STREET
Deactivation Date
20 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9035415000
Graduation Year
1991 (35 years ago)
PAC ID
0648261198
Group Practice PAC ID
3375887052
Professional Enrollment ID
I20040521001236
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

  • East Travis Street, La Grange, Fayette County, Texas, 78945, United States

    LA GRANGE, TX 789452348

    Phone: (979) 968-3800

    Fax: (979) 968-2712

    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 78945)

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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: 3375887052View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1801890827 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes La Grange, Texas for Unknown Individual; expand the address list for detail.
What if La Grange, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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