Healthcare Provider Details

I. General information

NPI: 1114845344
Provider Name (Legal Business Name): ZACHARY AGRE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZACH AGRE PA-C

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 CATLIN DR
BARNHART MO
63012-1216
US

IV. Provider business mailing address

1717 CATLIN DR
BARNHART MO
63012-1216
US

V. Phone/Fax

Practice location:
  • Phone: 636-741-3233
  • Fax:
Mailing address:
  • Phone: 636-741-3233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: