Provider Demographics
NPI:1336503978
Name:FLOREZ, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FLOREZ
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 1:190 CIVIC CIR
Mailing Address - Street 2:#250
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3424
Mailing Address - Country:US
Mailing Address - Phone:972-219-1200
Mailing Address - Fax:
Practice Address - Street 1:190 CIVIC CIR
Practice Address - Street 2:#250
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3424
Practice Address - Country:US
Practice Address - Phone:972-219-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-10
Last Update Date:2016-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst