Individual provider Active NPI

Etenesh Molla, NP

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1043878259
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP138863 Issued in TX
Practice address
7200 Cambridge St FL 6
Houston, TX 77030-4202
Phone
(713) 798-2400
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X AP138863 TX
Nurse Practitioner 363L00000X AP138863 TX Primary
Family Nurse Practitioner 363LF0000X AP138863 TX

Addresses

Primary practice location

7200 Cambridge St FL 6
Houston, TX 77030-4202

Mailing address

18980 W Memorial Dr
Ste 100
Humble, TX 77338-4394
Phone (972) 693-3455

Other practice location 1

2727 Bolton Boone Dr Ste 109
DeSoto, TX 75115-2019
Phone (469) 988-4277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190723002949 TX Practitioner - Nurse Practitioner 5294061610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

7200 Cambridge St
FL 6
Houston, TX 77030-4202
Phone 71379817502

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138863TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Apr 15, 2025 Accepting new patients
Baylor College of Medicine CurrentSince Apr 15, 2025 Accepting new patients

Locations

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

7200 Cambridge St
Fl 6
Houston, TX 77030
Phone (713) 798-2545

17450 St Lukes Way
Ste 340
The Woodlands, TX 77384
Phone (936) 266-2645

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1043878259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18980 W MEMORIAL DR",
            "address_2": "STE 100",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384394",
            "telephone_number": "972-693-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST FL 6",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202",
            "telephone_number": "713-798-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 Bolton Boone Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "DeSoto",
            "state": "TX",
            "postal_code": "751152019",
            "country_code": "US",
            "telephone_number": "469-988-4277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLLA",
        "first_name": "ETENESH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TX",
            "license": "AP138863",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP138863",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.