Provider Demographics
NPI:1184865933
Name:ENOH, MANFRED
Entity Type:Individual
Prefix:
First Name:MANFRED
Middle Name:
Last Name:ENOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 FALCON PERCH CIR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-7635
Mailing Address - Country:US
Mailing Address - Phone:817-563-6561
Mailing Address - Fax:817-563-6561
Practice Address - Street 1:4301 FALCON PERCH CIR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-7635
Practice Address - Country:US
Practice Address - Phone:817-563-6561
Practice Address - Fax:817-563-6561
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-07
Last Update Date:2009-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator