Unknown Individual – Family Medicine Physician, NPI 1679569032
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1523, Hanover Road, Wichita Falls, Wichita County, Texas, 76302, United States
WICHITA FALLS, TX 763024113
Phone: (940) 867-1332
Type: Mailing
1523 Hanover Rd
Wichita Falls, TX 763024113
Phone: (940) 867-1332
Type: Location
219 N Polk St
Jefferson, TX 756572131
Phone: (903) 665-2600
Fax: (703) 665-2608
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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.
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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 76302)
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