Healthcare Provider Details

I. General information

NPI: 1245142371
Provider Name (Legal Business Name): ESMERALDA SOSA LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 TROJAN DR
CORPUS CHRISTI TX
78416-1319
US

IV. Provider business mailing address

6301 MEADOWVISTA DR APT 414
CORPUS CHRISTI TX
78414-2634
US

V. Phone/Fax

Practice location:
  • Phone: 361-878-7340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT9763
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: