Provider Demographics
NPI:1003784513
Name:ISRAEL, ENOS
Entity type:Individual
Prefix:
First Name:ENOS
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 CHAROLAIS DR APT D
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-2568
Mailing Address - Country:US
Mailing Address - Phone:254-350-4080
Mailing Address - Fax:
Practice Address - Street 1:175 WESTFIELD BLVD STE 120
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-4524
Practice Address - Country:US
Practice Address - Phone:254-677-7235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician