Provider Demographics
NPI:1235641507
Name:ENRIQUEZ, CHRISTOPHER CARLITO (OPA-C, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:CARLITO
Last Name:ENRIQUEZ
Suffix:
Gender:M
Credentials:OPA-C, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11017 FREEMONT TRL
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-6717
Mailing Address - Country:US
Mailing Address - Phone:417-283-1434
Mailing Address - Fax:
Practice Address - Street 1:1813 MASSEY LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-1676
Practice Address - Country:US
Practice Address - Phone:417-283-1434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT67682255A2300X
TX1322246ZX2200X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant