MEDICARE: CYNTHIA LISKA

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	225X00000X	Occupational Therapist	104412	TX

General Provider Information

NPI Number	:	1154464014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA LISKA

Provider Business Mailing Address
First Line	:	18484 PRESTON RD
Second Line	:	SUITE 102, PMB 156
City	:	DALLAS
State	:	TX
Zip	:	75252-5400
Country	:	US
Telephone Number	:	972-342-7419
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 INTERSTATE 45 S STE 4
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-5649
Country	:	US
Telephone Number	:	936-293-8800
Fax Number	:

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	05/02/2025

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Directions to “ CYNTHIA LISKA ” Practice Location

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