Provider Demographics
NPI:1881279511
Name:AGAPE-TX CHIROPRACTIC CO
Entity type:Organization
Organization Name:AGAPE-TX CHIROPRACTIC CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-218-7956
Mailing Address - Street 1:1697 GORDON RD
Mailing Address - Street 2:
Mailing Address - City:WHITEWRIGHT
Mailing Address - State:TX
Mailing Address - Zip Code:75491-7159
Mailing Address - Country:US
Mailing Address - Phone:214-218-7956
Mailing Address - Fax:
Practice Address - Street 1:1697 GORDON RD
Practice Address - Street 2:
Practice Address - City:WHITEWRIGHT
Practice Address - State:TX
Practice Address - Zip Code:75491-7159
Practice Address - Country:US
Practice Address - Phone:214-218-7956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty