Healthcare Provider Details

I. General information

NPI: 1093636037
Provider Name (Legal Business Name): SARA LOUISA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 MAIN ST. UNIT 1503
KATY TX
77494
US

IV. Provider business mailing address

22107 SHADY HEATH LN
KATY TX
77494-4693
US

V. Phone/Fax

Practice location:
  • Phone: 956-442-5778
  • Fax:
Mailing address:
  • Phone: 956-442-5778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number102840
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: