Provider Demographics
NPI:1851526818
Name:ZAPATA, LILLIAN BOTTS (COSMETOLOGIST SPECIA)
Entity Type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:BOTTS
Last Name:ZAPATA
Suffix:
Gender:F
Credentials:COSMETOLOGIST SPECIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9200 BROADWAY
Mailing Address - Street 2:SUITE125E
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217
Mailing Address - Country:US
Mailing Address - Phone:210-824-5299
Mailing Address - Fax:210-824-5299
Practice Address - Street 1:9200 BROADWAY ST
Practice Address - Street 2:SUITE125E
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5901
Practice Address - Country:US
Practice Address - Phone:210-824-5299
Practice Address - Fax:210-824-5299
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1081953174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist