Individual ProviderLydia GonzalezPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6601 Montana Ave, Ste G, El Paso, TX 79925-2155(915) 838-7604PECOS EnrollmentBased on the most recent information from CMS, provider Lydia Gonzalez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:58 AM.Profile DetailsProvider ID1205090651Provider TypeIndividualFull NameGonzalez, LydiaCredentialPTGenderFemaleSole ProprietorNoEnumeration Date7/15/2008Last Updated7/15/2008Contact InformationPractice LocationPractice Address6601 Montana Ave, Ste G, El Paso, TX 79925-2155Phone(915) 838-7604FaxUnlisted FaxMailing LocationMailing Address1901 Thunder Rdg, El Paso, TX 79938-4620PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1105740Texas