Provider Demographics
NPI:1083381503
Name:AGAPE INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:AGAPE INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:512-817-6235
Mailing Address - Street 1:13513 CLERK ST
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-6288
Mailing Address - Country:US
Mailing Address - Phone:512-817-6235
Mailing Address - Fax:
Practice Address - Street 1:701 FM 685 STE 135
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2899
Practice Address - Country:US
Practice Address - Phone:512-291-3808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center