Provider Demographics
NPI:1821765165
Name:OSBORNE, MERLENA NYKIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MERLENA
Middle Name:NYKIA
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 MILL RIVER DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5044
Mailing Address - Country:US
Mailing Address - Phone:918-814-8439
Mailing Address - Fax:
Practice Address - Street 1:3334 N TOWN EAST BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3800
Practice Address - Country:US
Practice Address - Phone:972-681-8321
Practice Address - Fax:972-613-8927
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor