Unknown Individual – Diagnostic Radiology Physician, NPI 1831190875

Unknown Individual is a healthcare provider. based in Fort worth, Texas. specializing in Diagnostic Radiology Physician. They hold a License No. G1448 (TX). The NPI Number for Unknown Individual is 1831190875

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1831190875
Phone
(817) 321-0404
Address
815 PENNSYLVANIA AVE
Deactivation Date
6 December 2023

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
2144205400
Graduation Year
1980 (46 years ago)
PAC ID
7315841095
Group Practice PAC ID
3072836600
Professional Enrollment ID
I20031124000612
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

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Provider Addresses for Unknown Individual

  • 815, Pennsylvania Avenue, Fort Worth, Tarrant County, Texas, 76104, United States

    FORT WORTH, TX 761042224

    Phone: (817) 321-0404

    Type: Mailing

  • 1750, North Hampton Road, De Soto, DeSoto, Dallas County, Texas, 75115, United States

    DESOTO, TX 751152306

    Phone: (214) 946-4397

    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 76104)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYTX71250CT scan chest3636
DIAGNOSTIC RADIOLOGYTX73110X-ray of wrist, minimum of 3 views1111
DIAGNOSTIC RADIOLOGYTX73630X-ray of foot, minimum of 3 views4644

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: 3072836600View full group profile
NameSpecialtyState
TIMOTHY J LEIHGEBER (MD)
Diagnostic RadiologyTX
ALFRED LLAVE (M.D.)
Diagnostic RadiologyTX
WILLIAM CHRISTOPHER JR. SMITH (M.D.)
Diagnostic RadiologyTX
DR. MOHAMMAD ATIF KHALID (M.D.)
Diagnostic RadiologyNJ
ERIC WEISSMANN
Diagnostic RadiologyTX
RYAN M ALEXANDER (DO)
Diagnostic RadiologyTX
JOHN D WILSON (MD)
Diagnostic RadiologyTX
DR. ERIC JAMES ANDREWS (M.D.)
Diagnostic RadiologyTX
MICHELLE MOATE (MD)
Diagnostic RadiologyTX
GAIL ELIZABETH AZNAVORIAN-BENTLEY (MD)
Diagnostic RadiologyTX

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1831190875 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Fort Worth, Texas for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1831190875. Always confirm identity and privileges with the practice and licensing boards.

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