Provider Demographics
NPI:1649740200
Name:LIETZ, PAUL JAMES III (DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JAMES
Last Name:LIETZ
Suffix:III
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 UNIVERSITY OAKS BLVD STE 500
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-2429
Practice Address - Country:US
Practice Address - Phone:512-766-2171
Practice Address - Fax:512-766-2172
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTT342252251X0800X
TX1331811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic