Provider Demographics
NPI:1508289653
Name:AMAYA, LILLIAN GARCIA (OT)
Entity Type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:GARCIA
Last Name:AMAYA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:LILLIAN
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:10803 HUNTERS WAY
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4250
Mailing Address - Country:US
Mailing Address - Phone:210-281-5401
Mailing Address - Fax:210-281-5401
Practice Address - Street 1:5304 NEW FOREST DRIVE
Practice Address - Street 2:#8309
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5401
Practice Address - Country:US
Practice Address - Phone:210-281-5401
Practice Address - Fax:210-281-5401
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102692225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102692OtherEXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS