Provider Demographics
NPI:1548267651
Name:ENLOW, RICK LYNN (FNP-C, DC)
Entity type:Individual
Prefix:DR
First Name:RICK
Middle Name:LYNN
Last Name:ENLOW
Suffix:
Gender:M
Credentials:FNP-C, 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 STE 408
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6687
Mailing Address - Country:US
Mailing Address - Phone:817-520-5260
Mailing Address - Fax:817-520-5279
Practice Address - Street 1:6805 NE LOOP 820 STE 408
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76180-6687
Practice Address - Country:US
Practice Address - Phone:817-520-5260
Practice Address - Fax:817-520-5279
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4224111N00000X
TX778736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13180Medicare UPIN
TX84W910Medicare PIN