Active NPI
Noe S Perez
- Primary Care Nurse Practitioner
- Katy, TX
National Provider Identifier
1558180125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 1176642
- Practice address
- 21416 Provincial Blvd
Katy, TX 77450-7587 - Phone
- (832) 970-2500
- NPI assigned
- Oct 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 1176642 | TX | Primary |
Addresses
Primary practice location
21416 Provincial Blvd
Katy, TX 77450-7587
Mailing address
21416 Provincial Blvd
Katy, TX 77450-7587
Phone (832) 970-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1176642 | TX | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifetime Healthcare Inc | Current | Accepting new patients |
Locations
1820 S Mason Rd
Ste 320
Katy, TX 77450
Phone (281) 602-0800
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753401600000",
"number": "1558180125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21416 PROVINCIAL BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774507587",
"telephone_number": "832-970-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21416 PROVINCIAL BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774507587",
"telephone_number": "832-970-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "NOE",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-09",
"last_updated": "2025-07-25",
"certification_date": "2025-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TX",
"license": "1176642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.