Provider Demographics
NPI:1265058978
Name:SOULE-SARINANA, LISA JANICE (PT, DPT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:JANICE
Last Name:SOULE-SARINANA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9611 ACER AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-6719
Mailing Address - Country:US
Mailing Address - Phone:915-300-0005
Mailing Address - Fax:915-300-0008
Practice Address - Street 1:9611 ACER AVE STE 114
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-6719
Practice Address - Country:US
Practice Address - Phone:915-300-0005
Practice Address - Fax:915-300-0008
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1331566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist