Provider Demographics
NPI:1821172677
Name:PEREZ, MONICA PEREZ (PLC)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:PEREZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13615 SAINT MARYS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3439
Mailing Address - Country:US
Mailing Address - Phone:713-828-0593
Mailing Address - Fax:713-784-4040
Practice Address - Street 1:13615 SAINT MARYS LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3439
Practice Address - Country:US
Practice Address - Phone:713-828-0593
Practice Address - Fax:713-784-4040
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX16824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150276701Medicaid