Unknown Individual – Obstetrics & Gynecology Physician, NPI 1962451484

Unknown Individual is a healthcare provider. based in Colleyville, Texas. specializing in Obstetrics & Gynecology Physician. They hold a License No. K9102 (TX). The NPI Number for Unknown Individual is 1962451484

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962451484
Phone
(817) 812-3044
Address
PO BOX 2091
Deactivation Date
6 September 2023

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
5092743906
Professional Enrollment ID
I20060609000149
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

  • Colleyville Post Office, Hall Johnson Road, Colleyville, Tarrant County, Texas, 76051, United States

    COLLEYVILLE, TX 760342091

    Phone: (817) 812-3044

    Fax: (817) 796-1378

    Type: Mailing

  • North Park Boulevard, Grapevine, Tarrant County, Texas, 76051, United States

    STE 105

    GRAPEVINE, TX 760516985

    Phone: (817) 812-3044

    Fax: (817) 796-1378

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 28 Open Payments records for all available years, with a total value of $17,655.

Total Amount is formed as General ($17,655) + Research ($0) + Ownership ($0) = $17,655.

Last reported payment date: 2023-07-24 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($17,251).

Total Amount

$17,655

General + Research + Ownership

Payments

28

Total payment records

General Amount

$17,655

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-24

Latest reported date

Top Companies

Largest payers in this snapshot

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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 76034)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1962451484; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Colleyville, Texas for Unknown Individual based on available NPPES addresses.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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