Provider Demographics
NPI:1154551240
Name:ENABORE, DARRYL M (PT, RN)
Entity type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:M
Last Name:ENABORE
Suffix:
Gender:M
Credentials:PT, RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:7503 QUAIL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3469
Mailing Address - Country:US
Mailing Address - Phone:469-688-3890
Mailing Address - Fax:817-472-5084
Practice Address - Street 1:7503 QUAIL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3469
Practice Address - Country:US
Practice Address - Phone:469-688-3890
Practice Address - Fax:817-472-5084
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX738346163W00000X
TX1072742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No163W00000XNursing Service ProvidersRegistered Nurse