Unknown Individual – Family Medicine Physician, NPI 1790704997

Unknown Individual is a healthcare provider. based in Kingwood, Texas. specializing in Family Medicine Physician. They hold a License No. J1384 (TX). The NPI Number for Unknown Individual is 1790704997

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790704997
Phone
(806) 773-6836
Address
4582 KINGWOOD DR
Deactivation Date
8 March 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Kingwood Drive, Kingwood Lakes, Houston, Harris County, Texas, 77339, United States

    E107

    KINGWOOD, TX 773452639

    Phone: (806) 773-6836

    Fax: (806) 773-6836

    Type: Mailing

  • Kingwood Drive, Kingwood, Houston, Harris County, Texas, 77345, United States

    KINGWOOD, TX 773393042

    Phone: (281) 247-7289

    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.

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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 77345)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1790704997 — is the standard way to identify this listing.
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 specialty?
The listing groups Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Kingwood, Texas in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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