Provider Demographics
NPI:1720102064
Name:ENLOW, BILL WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:WAYNE
Last Name:ENLOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 NE LOOP 820
Mailing Address - Street 2:SUITE 414
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6687
Mailing Address - Country:US
Mailing Address - Phone:817-581-7246
Mailing Address - Fax:817-581-7248
Practice Address - Street 1:6805 NE LOOP 820
Practice Address - Street 2:SUITE 414
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76180-6687
Practice Address - Country:US
Practice Address - Phone:817-581-7246
Practice Address - Fax:817-581-7248
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor