Healthcare Provider Details

I. General information

NPI: 1447713730
Provider Name (Legal Business Name): SAMUEL ENYEW DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 N. FM 3167, UNIT 3
RIO GRANDE CITY TX
78582-6211
US

IV. Provider business mailing address

216 N FM 3167 UNIT 3
RIO GRANDE CITY TX
78582-6207
US

V. Phone/Fax

Practice location:
  • Phone: 956-255-5891
  • Fax: 956-340-4609
Mailing address:
  • Phone: 443-985-8548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number692026
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number692026
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: