Unknown Individual – Internal Medicine Physician, NPI 1124063995

Unknown Individual is a healthcare provider. based in Burleson, Texas. specializing in Internal Medicine Physician. They hold a License No. J7923 (TX). The NPI Number for Unknown Individual is 1124063995

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124063995
Phone
(817) 447-9900
Address
714 SW WILSHIRE BLVD
Deactivation Date
9 June 2021
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

  • 714, Southwest Wilshire Boulevard, Burleson, Johnson County, Texas, 76028, United States

    BURLESON, TX 760285711

    Phone: (817) 447-9900

    Fax: (817) 447-5010

    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 76028)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1124063995.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Burleson, Texas in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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