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General NPI Number Information
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NPI Number | 1316741101
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Entity Type | Organization
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Legal Business Name | AGAPE FAMILY CLINIC LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 12028 S NORWOOD AVE STE 100
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City | TULSA
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State | OK
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Zip | 74137-5545
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Country | US
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Telephone | 918-819-8164
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Fax |
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Provider Business Mailing Address
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Address Line | 12028 S NORWOOD AVE STE 100
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City | TULSA
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State | OK
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Zip | 74137-5545
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | PHENG CING
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Credential | APRN-CNP
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Telephone | 918-819-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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