Provider Demographics
NPI:1962144634
Name:LIRA, CHRISTIAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:LIRA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8602 CINNAMON CREEK DR APT 1306
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1469
Mailing Address - Country:US
Mailing Address - Phone:361-903-2350
Mailing Address - Fax:
Practice Address - Street 1:7208 NE CORNELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5430
Practice Address - Country:US
Practice Address - Phone:971-353-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1352684225100000X
OR0736434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist