Provider Demographics
NPI:1992333629
Name:PEREZ, SARA IZAMAR
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:IZAMAR
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:IZAMAR
Other - Last Name:PEREZ MATA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1200 E SAVANNAH AVE STE 16
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1728
Mailing Address - Country:US
Mailing Address - Phone:956-631-3344
Mailing Address - Fax:956-631-3881
Practice Address - Street 1:1200 E SAVANNAH AVE STE 16
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1728
Practice Address - Country:US
Practice Address - Phone:956-631-3344
Practice Address - Fax:956-631-3881
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13557363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant