Provider Demographics
NPI:1437723723
Name:HERRERA, ALEXIA LIZBETH (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:LIZBETH
Last Name:HERRERA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:WILFORD HALL AMBULATORY CENTER
Mailing Address - Street 2:1100 WILFORD HALL LOOP
Mailing Address - City:JBSA-LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236
Mailing Address - Country:US
Mailing Address - Phone:210-292-7749
Mailing Address - Fax:
Practice Address - Street 1:WILFORD HALL AMBULATORY CENTER
Practice Address - Street 2:1100 WILFORD HALL LOOP
Practice Address - City:JBSA-LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-4660
Practice Address - Country:US
Practice Address - Phone:210-292-7749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31265592251P0200X
TX1348718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics