Provider Demographics
NPI:1487737219
Name:ENRIQUEZ, OSCAR OLFINDO (MD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:OLFINDO
Last Name:ENRIQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4580 MSC# 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4580
Mailing Address - Country:US
Mailing Address - Phone:409-727-2808
Mailing Address - Fax:409-727-5933
Practice Address - Street 1:2801 MACARTHUR DR STE E
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4791
Practice Address - Country:US
Practice Address - Phone:409-920-4037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0026207QA0000X, 207RA0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105667304Medicaid
TX1487737219OtherNPI INDIVIDUAL
TX172115101Medicaid
TX172115101Medicaid