Provider Demographics
NPI:1275396533
Name:GOVEA, LILIANA ABIGAIL (PA-C)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:ABIGAIL
Last Name:GOVEA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 PAIL PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-4538
Mailing Address - Country:US
Mailing Address - Phone:210-310-8091
Mailing Address - Fax:
Practice Address - Street 1:1511 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-4006
Practice Address - Country:US
Practice Address - Phone:210-433-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17626363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant