Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1134197064

Unknown Individual is a healthcare provider. based in Fredericksburg, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 525966 (TX). The NPI Number for Unknown Individual is 1134197064

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1134197064
Phone
(830) 997-9170
Address
415 S WASHINGTON ST
Deactivation Date
4 January 2023
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

  • 415, South Washington Street, Fredericksburg, Gillespie County, Texas, 78624, United States

    FREDERICKSBURG, TX 786244636

    Phone: (830) 997-9170

    Fax: (830) 997-9226

    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 78624)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1134197064 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Fredericksburg?
Public fields place Unknown Individual around Fredericksburg, 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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