Healthcare Provider Details

I. General information

NPI: 1881279511
Provider Name (Legal Business Name): AGAPE-TX CHIROPRACTIC CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1697 GORDON RD
WHITEWRIGHT TX
75491-7159
US

IV. Provider business mailing address

1697 GORDON RD
WHITEWRIGHT TX
75491-7159
US

V. Phone/Fax

Practice location:
  • Phone: 214-218-7956
  • Fax:
Mailing address:
  • Phone: 214-218-7956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: WILLIE OW
Title or Position: PROVIDER
Credential: DC
Phone: 214-218-7956