Unknown Individual – Ophthalmology Physician, NPI 1366448375

Unknown Individual is a healthcare provider. based in Fort worth, Texas. specializing in Ophthalmology Physician. They hold a License No. E4236 (TX). The NPI Number for Unknown Individual is 1366448375

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366448375
Phone
(817) 332-2020
Address
1201 SUMMIT AVE
Deactivation Date
1 March 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

  • 1201, Summit Avenue, Fort Worth, Tarrant County, Texas, 76102, United States

    FORT WORTH, TX 761024427

    Phone: (817) 332-2020

    Fax: (817) 332-4797

    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 76102)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYTX92083Measurement of field of vision during daylight conditions116111
OPHTHALMOLOGYTX92134Diagnostic imaging of retina136133

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1366448375 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Where in Texas is Unknown Individual registered?
Use Fort Worth, Texas as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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