Provider Demographics
NPI:1649751280
Name:LERMA, MANUEL ALEJANDRO (PT, DPT, LAT, ATC)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ALEJANDRO
Last Name:LERMA
Suffix:
Gender:M
Credentials:PT, DPT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 W HIGHWAY 71 APT 728
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8178
Mailing Address - Country:US
Mailing Address - Phone:956-414-5770
Mailing Address - Fax:
Practice Address - Street 1:8600 W HIGHWAY 71 APT 728
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8178
Practice Address - Country:US
Practice Address - Phone:956-414-5770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT94472255A2300X
TX1397505225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer