MEDICARE: DR. ANA LILIA LIZA DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1177523	TX

General Provider Information

NPI Number	:	1134300874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA LILIA LIZA DPT

Provider Business Mailing Address
First Line	:	1904 GRANDSTAND DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-4508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1904 GRANDSTAND DRIVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-4508
Country	:	US
Telephone Number	:	210-520-8070
Fax Number	:	210-520-8070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2007
Last Update Date	:	05/15/2012

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