Provider Demographics
NPI:1467575670
Name:ANDRES S ENRIQUEZ MD PA
Entity Type:Organization
Organization Name:ANDRES S ENRIQUEZ MD PA
Other - Org Name:FRANKLIN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:S
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-833-8444
Mailing Address - Street 1:836 E REDD RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7221
Mailing Address - Country:US
Mailing Address - Phone:915-833-8444
Mailing Address - Fax:915-833-8767
Practice Address - Street 1:836 E REDD RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7221
Practice Address - Country:US
Practice Address - Phone:915-833-8444
Practice Address - Fax:915-833-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0096EROtherBC BS TX
TX628635OtherANTHEM BX
TXMDK7149OtherWORKERS COMPENSATION
TX080165782OtherMEDICARE RAILROAD
P2139868OtherOXFORD INSURNACE
TX178232700OtherOWCP DOL
2032372OtherUNITED HEALTH CARE
TX8A3420OtherBC BS TX
NMNM009379OtherBC BS NM
TX628635OtherANTHEM BX
TX00130MMedicare PIN