Provider Demographics
NPI:1528043908
Name:POWELL, KARA KARRH (DPT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:KARRH
Last Name:POWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:KATHRYN
Other - Last Name:KARRH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 SPURS LN
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1679
Mailing Address - Country:US
Mailing Address - Phone:210-699-8326
Mailing Address - Fax:210-561-7121
Practice Address - Street 1:21 SPURS LN
Practice Address - Street 2:STE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1679
Practice Address - Country:US
Practice Address - Phone:210-699-8326
Practice Address - Fax:210-561-7121
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139848225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6978OtherBCBSTX
TX11659743OtherCAQH
TX213861201Medicaid
TX213861201Medicaid
TXP00931236Medicare PIN