Individual provider Active NPI

Shantrae Moore

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1992258131
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
757931 Issued in TX
Practice address
5603 FM 1960 Rd W
Houston, TX 77069-4219
Phone
(281) 397-4030
Fax
(281) 397-0604
NPI assigned
Jul 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 757931 TX Primary

Addresses

Primary practice location

5603 FM 1960 Rd W
Houston, TX 77069-4219

Mailing address

5603 FM 1960 Rd W
Houston, TX 77069-4219
Phone (281) 397-4030

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
I20170124002916 TX Practitioner - Nurse Practitioner 0547542672 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
757931TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Hope Foundation, Inc CurrentSince Aug 22, 2016 Accepting new patients
St. Hope Foundation, Inc CurrentSince Aug 22, 2016 Accepting new patients
St Hope Foundation Inc Current Accepting new patients
Tri-County Behavioral Healthcare CurrentSince Jan 25, 2021 Accepting new patients
St. Hope Foundation, Inc - Dental Past Accepting new patients

Locations

6800 West Loop S
Ste 560
Bellaire, TX 77401
Phone (713) 839-7111

233 Sgt Ed Holcomb Blvd S
Conroe, TX 77304
Phone (936) 521-6151

706 Old Montgomery Rd
Conroe, TX 77301
Phone (936) 538-1102

1414 S Frazier St
Ste 105
Conroe, TX 77301
Phone (936) 441-2440

1414 S Frazier St
Conroe, TX 77301
Phone (936) 494-2455

3750 Medical Park Blvd
Ste 150
Dickinson, TX 77539
Phone (832) 738-1305

6200 Savoy Dr
Ste 540
Houston, TX 77036
Phone (713) 778-1300

255 Northpoint Dr
Ste 200
Houston, TX 77060
Phone (832) 300-8040

Organizations & group practices 5

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": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1992258131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694219",
            "telephone_number": "281-397-4030",
            "fax_number": "281-397-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694219",
            "telephone_number": "281-397-4030",
            "fax_number": "281-397-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANTRAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-24",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "757931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.