Unknown Individual – General Practice Physician, NPI 1861496580

Unknown Individual is a healthcare provider. based in Fort worth, Texas. specializing in General Practice Physician. They hold a License No. J-0651 (TX). The NPI Number for Unknown Individual is 1861496580

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861496580
Phone
(682) 777-4008
Address
2737 S HULEN ST
Deactivation Date
23 January 2025

Doctor Profile

Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6827774008
Graduation Year
1977 (49 years ago)
PAC ID
1951350321
Professional Enrollment ID
I20050113000110
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2737, South Hulen Street, Fort Worth, Tarrant County, Texas, 76109, United States

    FORT WORTH, TX 761099535

    Phone: (682) 777-4008

    Fax: (817) 927-7568

    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 76109)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1861496580 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes General Practice Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Fort Worth, Texas as the reference point for Unknown Individual, then confirm.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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