Basic Information
Provider Information
NPI: 1699419200
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIL
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: QMPC-CS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 CRAWFORD ST STE 208
Address2:  
City: HOUSTON
State: TX
PostalCode: 770028941
CountryCode: US
TelephoneNumber: 2253854543
FaxNumber: 8668259703
Practice Location
Address1: 2101 CRAWFORD ST STE 208
Address2:  
City: HOUSTON
State: TX
PostalCode: 770028941
CountryCode: US
TelephoneNumber: 2253854543
FaxNumber: 8668259703
Other Information
ProviderEnumerationDate: 04/21/2022
LastUpdateDate: 04/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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