Individual provider Active NPI

Sandra Perez, FNP-BC

  • Family Nurse Practitioner
  • Longview, TX
National Provider Identifier
1023863586
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1137563 Issued in TX
Practice address
1201 W Loop 281 Ste 302
Longview, TX 75604-2941
Phone
(903) 212-0556
NPI assigned
Apr 18, 2024
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1137563 TX Primary

Addresses

Primary practice location

1201 W Loop 281 Ste 302
Longview, TX 75604-2941

Mailing address

1201 W Loop 281 Ste 302
Longview, TX 75604-2941
Phone (903) 212-0556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925002981 TX Practitioner - Nurse Practitioner 5698270031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Sep 1, 2025 Accepting new patients
Etmc Physician Group Inc. CurrentSince Oct 1, 2025 Accepting new patients
Etmc Physician Group Inc. CurrentSince Oct 1, 2025 Accepting new patients
Galaxy Wellness Services LLC CurrentSince Apr 21, 2024 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Sep 1, 2025 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1201 W Loop 281
Ste 302
Longview, TX 75604
Phone (903) 212-0556

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

700 Olympic Plaza Cir
Ste 508
Tyler, TX 75701
Phone (903) 526-3030

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1023863586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LOOP 281 STE 302",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042941",
            "telephone_number": "903-212-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LOOP 281 STE 302",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042941",
            "telephone_number": "903-212-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SANDRA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1137563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.