Unknown Individual – Physical Therapist, NPI 1811958358

Unknown Individual is a healthcare provider. based in Longview, Texas. specializing in Physical Therapist. They hold a License No. 1068211 (TX). The NPI Number for Unknown Individual is 1811958358

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1811958358
Phone
(903) 753-6635
Address
3202 4TH ST STE 101
Deactivation Date
15 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9036652600
Graduation Year
1990 (36 years ago)
PAC ID
1557359536
Group Practice PAC ID
2769756345
Professional Enrollment ID
I20111027000388
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

Provider Addresses for Unknown Individual

  • 3202 4TH ST STE 101

    LONGVIEW, TX 756055143

    Phone: (903) 753-6635

    Fax: (903) 753-1114

    Type: Location

  • 219 N Polk St

    Jefferson, TX 756572131

    Phone: (903) 665-2600

    Fax: (903) 665-2608

    Type: Location

  • 908 Bomar St

    Marshall, TX 756706108

    Phone: (903) 935-3381

    Fax: (903) 935-0985

    Type: Location

  • Technology Center, Lost Creek Business Park, Longview, Gregg County, Texas, 75605, United States

    LONGVIEW, TX 756052697

    Phone: (903) 753-6635

    Fax: (903) 753-1114

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 75605)

Loading plans...

Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYTX97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes3627

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: 2769756345View full group profile
NameSpecialtyState
-TX

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1811958358.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Texas?
You will see Longview, Texas on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

Similar Providers

West 4th Street, Sunset Hills, Longview, Lee's Summit, Jackson County, Missouri, 64063, United States
NPI: 1114915188

VICTOR D KENNEL (PT)

Physical Therapist
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
NPI: 1730170309
AK Fitness Therapy Center, 2903, Judson Road, Longview, Gregg County, Texas, 75605, United States
NPI: 1992766950
822 N 4TH ST
NPI: 1144276577
3202 N 4TH ST
NPI: 1871540971

MRS. HEATHER D BROOKS (PT)

Physical Therapist
405 E MARSHALL ST
NPI: 1447293907

Direct RehabMed of Longview

Physical Therapist
100, West Hawkins Parkway, Longview, Gregg County, Texas, 75605, United States
NPI: 1518901214
CHRISTUS Good Shepherd NorthPark Medical Plaza, 323, East Hawkins Parkway, Longview, Gregg County, Texas, 75605, United States
NPI: 1093742835

LORI L HOLYFIELD (PT)

Physical Therapist
100, West Hawkins Parkway, Longview, Gregg County, Texas, 75605, United States
NPI: 1679507784