Active NPI
Misty Ann Shimada, PHARMACIST
- Pharmacist
- Houston, TX
National Provider Identifier
1366067308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 38913
- Practice address
- 4118 Pine Blossom TRL
Houston, TX 77059-3225 - Phone
- (281) 824-1480
- Fax
- (281) 220-6407
- NPI assigned
- Jun 16, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 38913 | TX | Primary |
Addresses
Primary practice location
4118 Pine Blossom TRL
Houston, TX 77059-3225
Mailing address
4118 Pine Blossom TRL
Houston, TX 77059-3225
Phone (281) 824-1480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38913 | Other | TX | TEXAS STATE BOARD OF EXAMINERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 38913 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1366067308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4118 PINE BLOSSOM TRL",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770593225",
"telephone_number": "281-824-1480",
"fax_number": "281-220-6407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4118 PINE BLOSSOM TRL",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770593225",
"telephone_number": "281-824-1480",
"fax_number": "281-220-6407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMADA",
"first_name": "MISTY",
"middle_name": "ANN",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "38913",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF EXAMINERS",
"identifier": "38913",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.