Provider Demographics
NPI:1023362845
Name:LYMAN, CELESTE PENDAZ (PT)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:PENDAZ
Last Name:LYMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 HALEY LN
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:TX
Mailing Address - Zip Code:78055-3528
Mailing Address - Country:US
Mailing Address - Phone:830-589-7215
Mailing Address - Fax:
Practice Address - Street 1:369 MARS DR
Practice Address - Street 2:
Practice Address - City:COTULLA
Practice Address - State:TX
Practice Address - Zip Code:78014-3146
Practice Address - Country:US
Practice Address - Phone:830-879-4483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist