Provider Demographics
NPI:1588604219
Name:AGAVE FAMILY PHYSICIANS PLLC
Entity Type:Organization
Organization Name:AGAVE FAMILY PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHATZKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-494-7778
Mailing Address - Street 1:21300 N JOHN WAYNE PARKWAY
Mailing Address - Street 2:STE 123
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239
Mailing Address - Country:US
Mailing Address - Phone:520-494-7778
Mailing Address - Fax:
Practice Address - Street 1:21300 N JOHN WAYNE PARKWAY
Practice Address - Street 2:STE 123
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85239
Practice Address - Country:US
Practice Address - Phone:520-494-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty