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1730709189
EMMANUEL IVAN ENRIQUEZ
FORT WORTH, TX
NPI
1730709189
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TX U5394)
Enumeration Date
2020-04-24
Last Update Date
2024-07-31
Business Address
EMMANUEL IVAN ENRIQUEZ
1500 S MAIN ST
FORT WORTH, TX 76104-4917
Phone number: 817-702-3431
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Mailing Address
EMMANUEL IVAN ENRIQUEZ
1500 S MAIN ST
FORT WORTH, TX 76104-4917
Phone number:
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