Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1139848 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1139848 | TX |
NPI | 1528043908 |
---|---|
Provider Name | Kara Karrh Powell |
First Address | San Antonio, TX 78240-1679 |
Second Address | San Antonio, TX 78240-1679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 11/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11659743 | CAQH (01) | TX |
213861201 | (05) | TX |
8T6978 | BCBSTX (01) | TX |