Provider Demographics
NPI:1578859666
Name:PERIASAMY, SANTHI (PHD)
Entity type:Individual
Prefix:
First Name:SANTHI
Middle Name:
Last Name:PERIASAMY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 LOUISIANA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-6616
Mailing Address - Country:US
Mailing Address - Phone:713-942-7793
Mailing Address - Fax:713-942-7795
Practice Address - Street 1:3303 LOUISIANA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-6616
Practice Address - Country:US
Practice Address - Phone:713-942-7793
Practice Address - Fax:713-942-7795
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33429103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling