Provider Demographics
NPI:1134300874
Name:LIZA, ANA LILIA (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:LILIA
Last Name:LIZA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ANA
Other - Middle Name:LILIA
Other - Last Name:YANEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1904 GRANDSTAND DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-4508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1904 GRANDSTAND DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-4508
Practice Address - Country:US
Practice Address - Phone:210-520-8070
Practice Address - Fax:210-520-8070
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177523225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist