Unknown Individual – Addiction Medicine (Family Medicine) Physician, NPI 1396136461

Unknown Individual is a healthcare provider. based in Bellaire, Texas. specializing in Addiction Medicine (Family Medicine) Physician. They hold a License No. 12004 (TX). The NPI Number for Unknown Individual is 1396136461

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1396136461
Phone
(713) 661-7888
Address
6565 WEST LOOP S
Deactivation Date
26 March 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:0State licenses:5Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 6565 WEST LOOP S

    SUITE 525

    BELLAIRE, TX 774013500

    Phone: (713) 661-7888

    Fax: (713) 661-7899

    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 77401)

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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 1396136461.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Addiction Medicine (Family Medicine) Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Bellaire, Texas in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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