RODOLFO ENRIQUEZ JR. (NPI# 1285812859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285812859 |
| Entity Type | Individual |
| Full Name | RODOLFO ENRIQUEZ JR. |
| Other Name | RUDY ENRIQUEZ JR. |
| Credential | OPA-C |
| Practice Address |
1901 Long Prairie Rd Ste 220-80 Flower Mound TX 75022-4246 |
| Practice Telephone | 2142272457 |
| Practice Fax Number | 2147640880 |
| Mailing Telephone | 2142272457 |
| Mailing Fax Number | 2147640888 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2019-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
OPAC990 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NBCOPA | OPA-C990 | 01 |
| Street Address |
1901 LONG PRAIRIE RD STE 220-80 |
| City | FLOWER MOUND |
| State | TX |
| Zip Code | 75022-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629006879 | Samir Sanmukh Desai | Physician Assistant | 1901 Long Prairie Rd Ste 220-80, Flower Mound, TX 75022-4246 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396356622 | Ann Ball | Nurse Practitioner | 2405 Bayshore Drive, Flower Mound, TX 75022 | 2020-08-11 |
| 1679183172 | Stacie Teresa Mccally | Nurse Practitioner | 4055 Valley View Lane, Dallas, TX 75022 | 2020-08-09 |
| 1194344812 | Today Dental of Flower Mound Pllc | Dentist | 2840 Flower Mound Rd, Suite 120, Flower Mound, TX 75022 | 2020-04-13 |
| 1801398375 | Lumincare Physician Group, Pa | Family Medicine | 2628 Long Prairie Road Suite 107, Flower Mound, TX 75022 | 2018-03-01 |
| 1861948572 | Icarepros, LLC | Home Health | 4508 Cassandra Drive, Flower Mound, TX 75022 | 2016-09-01 |
| 1912378837 | Tmj & Sleep Therapy Centre of North Texas, LLC | Dentist | 1005 Long Prairie Road, Suite 100, Flower Mound, TX 75022 | 2015-10-19 |
| 1689056863 | Twila Michelle Farrar | Counselor | 1033 Long Prairie Road, Suite 4, Flower Mound, TX 75022 | 2015-06-24 |
| 1992186597 | Kelly Fuller Lewis | Pediatrics | 3041 Churchill Dr Ste 300, Flower Mound, TX 75022 | 2015-06-09 |
| 1679989313 | Uap Keller Endo, LLC | Nurse Anesthetist, Certified Registered | 1001 Surrey Lane, Flower Mound, TX 75022 | 2014-07-02 |
| 1013269273 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 4301 Cross Timbers Rd., Flowermound, TX 75022 | 2012-10-11 |
| Find all providers in zip 75022 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629006879 | Samir Sanmukh Desai | Physician Assistant | 1901 Long Prairie Rd Ste 220-80, Flower Mound, TX 75022-4246 | 2006-06-28 |
| 1700867637 | Michelle Marie Wright | Physician Assistant | 4400 Long Prairie Rd, Flower Mound, TX 75028-1892 | 2005-11-08 |
| 1932653268 | Whitecoat Enterprises LLC | Physician Assistant | 1901 Long Prairie Rd, Suite 220-80, Flower Mound, TX 75022-4246 | 2016-08-03 |
| 1740657568 | Jacqueline Emily Evernham | Physician Assistant | 5000 Long Prairie Rd Ste 100, Flower Mound, TX 75028-2783 | 2015-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133340 | Mark Alan Williams | Physician Assistant | 4814 Lake Livingston Dr, Corpus Christi, TX 78413-5139 | 2020-10-28 |
| 1669081238 | Manuel V Leyva | Physician Assistant | 8407 Sunset Loch Dr, Spring, TX 77379-5121 | 2020-07-29 |
| 1194342212 | Sean Robert Jamieson | Physician Assistant | 2700 E Broad St Ste 200, Mansfield, TX 76063-5899 | 2020-07-06 |
| 1588284194 | Hill Country Surgical Management, Inc | Physician Assistant | 10454 Tippecanoe, San Antonio, TX 78245-3128 | 2020-04-23 |
| 1407475585 | Serenity Surgical Services | Physician Assistant | 3260 Springbok Cir, Frisco, TX 75034-3671 | 2020-04-09 |
| 1720610470 | Surgical Assistants of South Texas | Physician Assistant | 3414 Highway 146 S, La Porte, TX 77571-7400 | 2020-02-11 |
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1912558693 | Chandrant Akshar Pa | Physician Assistant | 400 W Arbrook Blvd Ste 230, Arlington, TX 76014-3174 | 2019-09-24 |
| 1700435831 | Christina A Vogel-rosbrook | Physician Assistant | 4330 Medical Drive, Suite 120, San Antonio, TX 78229-3353 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
| City | FLOWER MOUND |
| Zip Code | 75022 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.