Provider Demographics
NPI:1134719511
Name:PEREZ, KARLA P
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:P
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 W MORTON ST STE 122
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-1600
Mailing Address - Country:US
Mailing Address - Phone:903-462-0067
Mailing Address - Fax:
Practice Address - Street 1:2300 W MORTON ST STE 122
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1600
Practice Address - Country:US
Practice Address - Phone:903-462-0067
Practice Address - Fax:877-212-6291
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103720104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker