Provider Demographics
NPI:1740513407
Name:ADAME, LIZETTE (PT)
Entity type:Individual
Prefix:MRS
First Name:LIZETTE
Middle Name:
Last Name:ADAME
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LIZETTE
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1101 E SCHUSTER AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4659
Mailing Address - Country:US
Mailing Address - Phone:915-544-8484
Mailing Address - Fax:915-496-0751
Practice Address - Street 1:1101 E SCHUSTER AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4659
Practice Address - Country:US
Practice Address - Phone:915-544-8484
Practice Address - Fax:915-496-0751
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1189682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1189682OtherLICENSE #