Unknown Individual – Urology Physician, NPI 1871584128

Urology Physician

Unknown Individual is a healthcare provider. based in Amarillo, Texas. specializing in Urology Physician. They hold a License No. E7009 (TX). The NPI Number for Unknown Individual is 1871584128

Main info

Organization

Inactive

50 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1871584128

Phone

(806) 355-9447

Address

PO BOX 51800

Deactivation Date

19 March 2026

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8063559447

Graduation Year

1976 (50 years ago)

PAC ID

6608910328

Group Practice PAC ID

5890779227

Professional Enrollment ID

I20100218000887

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

PO BOX 51800
AMARILLO, TX 791591800
Phone: (806) 355-9447
Fax: (806) 356-9251
Type: Mailing
1900, Medi Park Drive, Amarillo, Potter County, Texas, 79106, United States
AMARILLO, TX 791062104
Phone: (806) 355-9447
Fax: (806) 356-9251
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 79159)

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Provider's Procedures

Unknown Individual performs procedures in Urology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
UROLOGY	TX	76942	Ultrasonic guidance imaging supervision and interpretation for insertion of needle	34	32

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: 5890779227View full group profile

Name	Specialty	State
MR. MATTHEW HOLCOMB (NP-C)	Nurse Practitioner	TX
JULIE HAMPTON (FNP-C)	Nurse Practitioner	TX
RICHARD GLENN III KIBBEY (MD)	-	TX
CHARLES SLOAN TEEPLE (MD)	U R O L O G Y	TX
DAVID WILHELM (MD)	U R O L O G Y	TX
NATALIE P GAINES (M.D.)	U R O L O G Y	TX
ROBERT HOUSTON RITTER (MD)	U R O L O G Y	TX
DR. IRFAN AHMED (MD)	Radiation Oncology, Internal Medicine	FL
RONALD WAYNE FORD (MD)	U R O L O G Y	TX
MRS. CHARITY LYNN GARDNER (ANP)	Nurse Practitioner	TX