Provider Demographics
NPI:1134253115
Name:LEAL, LIZ OLGUIN (OTR)
Entity type:Individual
Prefix:MRS
First Name:LIZ
Middle Name:OLGUIN
Last Name:LEAL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 ONYX WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-4152
Mailing Address - Country:US
Mailing Address - Phone:210-243-0341
Mailing Address - Fax:
Practice Address - Street 1:700 COLORADO BLVD # 318
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4084
Practice Address - Country:US
Practice Address - Phone:866-801-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208248224Z00000X
TX119081225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant