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General NPI Number Information
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NPI Number | 1285584268
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Entity Type | Organization
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Legal Business Name | ENRICHED LIFE MEDICAL, PLLC
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 2412 W MAIN ST
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City | GUN BARREL CITY
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State | TX
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Zip | 75156-3638
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Country | US
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Telephone | 903-309-9373
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Fax | 903-405-4573
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Provider Business Mailing Address
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Address Line | 2412 W MAIN ST
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City | GUN BARREL CITY
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State | TX
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Zip | 75156-3638
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Country | US
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Telephone | 903-309-9373
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Fax | 903-405-4573
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Authorized Official
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Title or Position | OWNER
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Name | JON RICH
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Credential | DO
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Telephone | 903-286-3182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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