Unknown Individual – Vascular Surgery Physician, NPI 1205832482

Unknown Individual is a healthcare provider. based in San antonio, Texas. specializing in Vascular Surgery Physician. They hold a License No. MDE7766 (TX). The NPI Number for Unknown Individual is 1205832482

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205832482
Phone
(210) 614-7414
Address
4330 MEDICAL DR
Deactivation Date
2 August 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

Provider Addresses for Unknown Individual

  • 4330 MEDICAL DR

    STE 120

    SAN ANTONIO, TX 782293342

    Phone: (210) 614-7414

    Fax: (210) 616-0509

    Type: Location

  • 5047 SHERRI ANN RD

    SAN ANTONIO, TX 782336213

    Phone: (210) 237-4400

    Fax: (210) 828-0590

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $57.

Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.

Last reported payment date: 2024-05-20 • Largest payer in this snapshot: Abbott Laboratories ($57).

Total Amount

$57

General + Research + Ownership

Payments

3

Total payment records

General Amount

$57

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$57
View all Open Payments →|Open Payments Risk Radar →

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 78229)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1205832482.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Vascular Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to San Antonio, Texas in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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