Provider Demographics
NPI:1518422351
Name:LEIJA, ANNIA FERNANDA (DPT)
Entity Type:Individual
Prefix:
First Name:ANNIA
Middle Name:FERNANDA
Last Name:LEIJA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CAS HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-3322
Mailing Address - Country:US
Mailing Address - Phone:210-303-2201
Mailing Address - Fax:
Practice Address - Street 1:1635 NE LOOP 410 STE 600
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1619
Practice Address - Country:US
Practice Address - Phone:210-457-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13125082251X0800X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic