Unknown Individual – Pediatrics Physician, NPI 1720059272

Unknown Individual is a healthcare provider. based in Waco, Texas. specializing in Pediatrics Physician. They hold a License No. C3052 (TX). The NPI Number for Unknown Individual is 1720059272

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1720059272
Phone
(254) 202-4660
Address
PO BOX 5338
Deactivation Date
16 November 2022
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

  • Waco Post Office, 86, Atlantic Avenue, Waco, Haralson County, Georgia, 30182, United States

    WACO, TX 76708

    Phone: (254) 202-4660

    Fax: (254) 202-4716

    Type: Mailing

  • Macarthur Drive, Waco, McLennan County, Texas, 76708, United States

    STE 103

    WACO, TX 76708

    Phone: (254) 202-6100

    Fax: (254) 202-6195

    Type: Location

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.

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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 76708)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1720059272 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Pediatrics Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Waco?
Public fields place Unknown Individual around Waco, Texas. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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