MEDICARE: DR. RENEE ENRIQUEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	261505	NY
2	208100000X	Physical Medicine & Rehabilitation Physician	R1021	TX
3	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	261505	NY
4	208100000X	Physical Medicine & Rehabilitation Physician	261505	NY
5	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	R1021	TX

General Provider Information

NPI Number	:	1780819318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENEE ENRIQUEZ MD

Provider Business Mailing Address
First Line	:	8210 MID CITIES BLVD STE 120
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-4701
Country	:	US
Telephone Number	:	817-969-6030
Fax Number	:	817-969-6039

Provider Business Practice Location Address
First Line	:	8210 MID CITIES BLVD STE 120
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-4701
Country	:	US
Telephone Number	:	817-969-6030
Fax Number	:	817-969-6039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2009
Last Update Date	:	01/02/2026

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Directions to “ DR. RENEE ENRIQUEZ MD” Practice Location

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