Unknown Individual – Family Medicine Physician, NPI 1912900531

Unknown Individual is a healthcare provider. based in Waco, Texas. specializing in Family Medicine Physician. They hold a License No. R0936 (TX). The NPI Number for Unknown Individual is 1912900531

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1912900531
Phone
(254) 313-4200
Address
1600 PROVIDENCE DR
Deactivation Date
3 January 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Providence Drive, Waco, McLennan County, Texas, 76707, United States

    WACO, TX 767072261

    Phone: (254) 313-4200

    Fax: (254) 313-4531

    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 76707)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1912900531 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Waco, Texas for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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