Provider Demographics
NPI:1811131964
Name:ENOH, SYLVIE NDJIE (PAC)
Entity type:Individual
Prefix:
First Name:SYLVIE
Middle Name:NDJIE
Last Name:ENOH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 MACARTHUR BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8259
Mailing Address - Country:US
Mailing Address - Phone:972-803-6789
Mailing Address - Fax:972-819-0050
Practice Address - Street 1:2681 MACARTHUR BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8259
Practice Address - Country:US
Practice Address - Phone:972-803-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06193363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203482904Medicaid
TX203482905Medicaid
NM84333049Medicaid
TX203482903Medicaid
TX203482905Medicaid
TXTXB139500Medicare PIN
NM84333049Medicaid
TX8L12948Medicare PIN