Unknown Individual – Otolaryngology Physician, NPI 1891752085

Unknown Individual is a healthcare provider. based in San angelo, Texas. specializing in Otolaryngology Physician. They hold a License No. D1639 (TX). The NPI Number for Unknown Individual is 1891752085

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1891752085
Phone
(325) 949-9555
Address
3555 KNICKERBOCKER RD
Deactivation Date
21 April 2021
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

  • Knickerbocker Road, San Angelo, Tom Green County, Texas, 76904, United States

    SAN ANGELO, TX 769047610

    Phone: (325) 949-9555

    Type: Mailing

  • Executive Drive, San Angelo, Tom Green County, Texas, 76909, United States

    SAN ANGELO, TX 769046884

    Phone: (325) 224-5211

    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 76904)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1891752085 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Otolaryngology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with San Angelo, Texas in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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