Individual provider Active NPI

Wyntria Lacabe-Moore, MD

  • Family Medicine Physician
  • Sugar Land, TX
National Provider Identifier
1053400135
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M4259 Issued in TX
Practice address
1403 Highway 6
Sugar Land, TX 77478-4930
Phone
(832) 260-0640
NPI assigned
Oct 12, 2006
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M4259 TX
Family Medicine Physician 207Q00000X M4259 TX Primary

Addresses

Primary practice location

1403 Highway 6
Sugar Land, TX 77478-4930

Mailing address

3960 Sunset Terrace Dr
League City, TX 77573-7793
Phone (281) 339-2916

Other identifiers 3

IdentifierTypeStateIssuer
179352303MedicaidTX
8V1563OtherTXBCBSTX
P00459908OtherTXRAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109001045 TX Practitioner - Family PracticePractitioner - Emergency Medicine 8527081264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Urgent Care PLLCGroup PAC ID 4880071679, 115 clinicians

Practice addresses (Care Compare)

19419 Gulf Fwy
Webster, TX 77598-2807
Phone (281) 316-0885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41031TXMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Urgent Care PLLC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
East Jefferson Family Practice L.L.C. Family Medicine Past Accepting new patients
Greater Houston Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

1505 E Winding Way Dr
Ste 112
Friendswood, TX 77546
Phone (281) 993-3860

2510 Smith Ranch Rd
Ste 102
Pearland, TX 77584
Phone (346) 439-7481

19419 Gulf Fwy
Ste 3
Webster, TX 77598
Phone (281) 316-0885

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AACHCD
  • Direct secure messaging: wyntria.lacabemoore@mhghuc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1053400135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 SUNSET TERRACE DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775737793",
            "telephone_number": "281-339-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 HIGHWAY 6",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784930",
            "telephone_number": "832-260-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACABE-MOORE",
        "first_name": "WYNTRIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M4259",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179352303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8V1563",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00459908",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.