Healthcare Provider Details

I. General information

NPI: 1861201451
Provider Name (Legal Business Name): SAGRERA & PANEQUE ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/14/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20611 FM 529 RD SUITE 108
CYPRESS TX
77433-8614
US

IV. Provider business mailing address

20611 FM 529 RD
CYPRESS TX
77433-8614
US

V. Phone/Fax

Practice location:
  • Phone: 281-400-1170
  • Fax: 281-400-1171
Mailing address:
  • Phone: 281-400-1170
  • Fax: 281-400-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ACIEL SAGRERA-MULEN
Title or Position: OWNER
Credential: DNP FNP, PMHNP, APRN
Phone: 281-400-1170