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NPI 1851816664

NPI 1851816664 : BRITTNEY COBURN M.ED, LAT, ATC : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1851816664
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    Entity Type          |    Individual 
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    Provider Name        |    BRITTNEY COBURN M.ED, LAT, ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/14/2017
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    Last Update Date     |    08/14/2017
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Provider Practice Location Address
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    Address Line         |    18200 KATY FWY STE 520 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77094-1285
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    Country              |    US
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    Telephone            |    832-227-2539
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11811 OWENS CANYON LN 
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    City                 |    CYPRESS
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    State                |    TX
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    Zip                  |    77433-2809
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    AT4624
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    License Number State |    TX
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