Unknown Individual – Orthopaedic Surgery Physician, NPI 1871593459

Unknown Individual is a healthcare provider. based in Texarkana, Texas. specializing in Orthopaedic Surgery Physician. They hold a License No. R3718 (AR). The NPI Number for Unknown Individual is 1871593459

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1871593459
Phone
(903) 792-5005
Address
1002 TEXAS BLVD.
Deactivation Date
10 August 2022

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
9036143000
Graduation Year
1981 (45 years ago)
PAC ID
9335126804
Group Practice PAC ID
1355249541
Professional Enrollment ID
I20040701001469
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1002, Texas Boulevard, Texarkana, Bowie County, Texas, 75501, United States

    SUITE 501

    TEXARKANA, TX 75501

    Phone: (903) 792-5005

    Fax: (903) 791-1569

    Type: Location

  • 5002, Cowhorn Creek Road, Texarkana, Bowie County, Texas, 75503, United States

    TEXARKANA, TX 755039766

    Phone: (903) 614-3000

    Fax: (903) 614-3525

    Type: Mailing

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 75501)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYTX27447Repair of knee joint2726

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: 1355249541View full group profile
NameSpecialtyState
VIRGINIA ANN PARKER (FNP)
Nurse PractitionerTX
LAURA L JACKSON (APRN, FNP)
-TX
WILMER LYNN REEP (MD)
-TX
MRS. KAYLA NICOLE STOCKTON (FNP-BC)
Nurse PractitionerAR
WILLIAM BOWLING (P.A)
Physician AssistantTX
NATHAN J WRIGHT (M.D.)
Internal MedicineTX
MRS. KIMBERLY ANN BENISH (APRN)
-TX
DR. BLANE A GRAVES (MD)
Family PracticeTX
DR. MICHELE MARIE CROCKETT (MD)
-TX
DR. GLEN A ROUNTREE (MD)
-TX

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1871593459 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Texas?
You will see Texarkana, Texas on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1871593459. Always confirm identity and privileges with the practice and licensing boards.

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