Provider Demographics
NPI:1851617161
Name:CORTEZ, LILLI (LMT)
Entity Type:Individual
Prefix:
First Name:LILLI
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 ALICIA DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5056
Mailing Address - Country:US
Mailing Address - Phone:806-223-5891
Mailing Address - Fax:806-353-1181
Practice Address - Street 1:3333 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2724
Practice Address - Country:US
Practice Address - Phone:806-353-0803
Practice Address - Fax:806-353-1181
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT109182172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist