Provider Demographics
NPI:1477893303
Name:LOMARQUEZ, LYNNETTE S (PT CLT)
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:S
Last Name:LOMARQUEZ
Suffix:
Gender:F
Credentials:PT CLT
Other - Prefix:
Other - First Name:LYNNETTE
Other - Middle Name:
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1351 N ZARAGOZA
Mailing Address - Street 2:BLDG Q
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-704-4065
Mailing Address - Fax:915-704-4067
Practice Address - Street 1:1351 N ZARAGOZA
Practice Address - Street 2:BLDG Q
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-704-4065
Practice Address - Fax:915-704-4067
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist