Provider Demographics
NPI:1124618384
Name:RESENDEZ, LIZEIDY
Entity type:Individual
Prefix:
First Name:LIZEIDY
Middle Name:
Last Name:RESENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 SANDWICK DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-5142
Mailing Address - Country:US
Mailing Address - Phone:956-800-9082
Mailing Address - Fax:
Practice Address - Street 1:4207 GARDENDALE ST STE 104B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3142
Practice Address - Country:US
Practice Address - Phone:210-582-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist