Unknown Individual – Sports Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1023662517

Unknown Individual is a healthcare provider. based in Arlington, Texas. specializing in Sports Medicine (Physical Medicine & Rehabilitation) Physician. They hold a License No. 2081107 (TX). The NPI Number for Unknown Individual is 1023662517

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1023662517
Phone
(210) 582-5840
Address
1112 E COPELAND RD STE 130
Deactivation Date
17 April 2025

Contacts

Secure Messaging
rudy.sanchez@agelesslivinghh.com
Main Contact
rudy.sanchez@agelesslivinghh.,com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • East Copeland Road, Arlington, Tarrant County, Texas, 76011, United States

    ARLINGTON, TX 760114992

    Phone: (210) 582-5840

    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 76011)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1023662517 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 expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Sports Medicine (Physical Medicine & Rehabilitation) Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Arlington?
Public fields place Unknown Individual around Arlington, Texas. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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