Individual provider Active NPI

Shenouda Mourgan

  • Pharmacist
  • Humble, TX
National Provider Identifier
1295335768
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52622 Issued in TX
Practice address
12815 Kinkaid Meadows LN
Humble, TX 77346-3794
Phone
(832) 295-8500
NPI assigned
Oct 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20075 NC
Pharmacist 183500000X 52622 TX Primary

Addresses

Primary practice location

12815 Kinkaid Meadows LN
Humble, TX 77346-3794

Mailing address

12815 Kinkaid Meadows LN
Humble, TX 77346-3794
Phone (832) 295-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
52622TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Merrimac Primecare, Inc Pharmacist CurrentSince Mar 11, 2025 Accepting new patients
Lonestar RX Inc Current Accepting new patients

Locations

15340 Vantage Pkwy E
Ste 220
Houston, TX 77032
Phone (410) 603-3559

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1295335768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12815 KINKAID MEADOWS LN",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463794",
            "telephone_number": "832-295-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 KINKAID MEADOWS LN",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463794",
            "telephone_number": "832-295-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURGAN",
        "first_name": "SHENOUDA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "20075",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "52622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.