Unknown Individual – Urology Physician, NPI 1174563639

Unknown Individual is a healthcare provider. based in Tyler, Texas. specializing in Urology Physician. They hold a License No. D6982 (TX). The NPI Number for Unknown Individual is 1174563639

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174563639
Phone
(903) 262-3900
Address
700 OLYMPIC PLAZA CIR
Deactivation Date
22 January 2021
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

  • Tyler Neurosurgical Associates, 700, Olympic Plaza Circle, Tyler, Smith County, Texas, 75701, United States

    #700

    TYLER, TX 757011951

    Phone: (903) 262-3900

    Fax: (903) 262-3993

    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 75701)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1174563639 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Urology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Tyler, Texas as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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