Provider Demographics
NPI:1972070308
Name:OSBURN, KARA LANE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:LANE
Last Name:OSBURN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 SARATOGA BLVD APT 126
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2964
Mailing Address - Country:US
Mailing Address - Phone:325-245-8477
Mailing Address - Fax:
Practice Address - Street 1:5502 SARATOGA BLVD APT 126
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2964
Practice Address - Country:US
Practice Address - Phone:325-245-8477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT66642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty