Active NPI
Mukosolu Egwim
- Psychiatric/Mental Health Nurse Practitioner
- Katy, TX
National Provider Identifier
1124962253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 70107389
- Practice address
- 4415 Upland Stream LN
Katy, TX 77493-3871 - Phone
- (512) 720-9855
- NPI assigned
- Apr 17, 2026
- Last updated
- Apr 17, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 70107389 | TX | Primary |
Addresses
Primary practice location
4415 Upland Stream LN
Katy, TX 77493-3871
Mailing address
4415 Upland Stream LN
Katy, TX 77493-3871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Austin, TX 78705
Phone (877) 779-2429
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70107389 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Austin, TX
- NPI 1841162856
-
- Mental Health Counselor
- Tukwila, WA
- NPI 1205466265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776384000000",
"number": "1124962253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4415 UPLAND STREAM LN",
"city": "KATY",
"state": "TX",
"postal_code": "774933871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4415 UPLAND STREAM LN",
"city": "KATY",
"state": "TX",
"postal_code": "774933871",
"telephone_number": "512-720-9855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGWIM",
"first_name": "MUKOSOLU",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-17",
"last_updated": "2026-04-17",
"certification_date": "2026-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "70107389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.