Provider Demographics
NPI:1528525425
Name:LIONEL, ANA PAULA GONCALVES (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:PAULA GONCALVES
Last Name:LIONEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 N LOOP 1604 E STE 101
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-2799
Mailing Address - Country:US
Mailing Address - Phone:210-590-4000
Mailing Address - Fax:210-590-4585
Practice Address - Street 1:6501 S CONGRESS AVE STE 301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4483
Practice Address - Country:US
Practice Address - Phone:512-270-2060
Practice Address - Fax:512-270-2061
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1314848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1314848OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS