Provider Demographics
NPI:1942417472
Name:A G A HEALTHCARE INC.
Entity Type:Organization
Organization Name:A G A HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:214-507-2831
Mailing Address - Street 1:11700 PRESTON RD STE 660
Mailing Address - Street 2:PMB 426
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2739
Mailing Address - Country:US
Mailing Address - Phone:214-507-2831
Mailing Address - Fax:
Practice Address - Street 1:11615 FOREST CENTRAL DR STE 214
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3910
Practice Address - Country:US
Practice Address - Phone:214-507-2831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4872111NS0005X
TX793295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603734Medicare ID - Type Unspecified
TXU20711Medicare UPIN