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General NPI Number Information
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NPI Number | 1346871480
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Entity Type | Organization
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Legal Business Name | AGAPE ANESTHESIA CRNA, PLLC
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 12222 N CENTRAL EXPY
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City | DALLAS
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State | TX
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Zip | 75243-3755
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Country | US
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Telephone | 972-972-4851
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 KELLER PKWY STE 108-429
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City | KELLER
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State | TX
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Zip | 76248-4601
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Country | US
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Telephone | 972-533-0098
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MALIA L STEPHENSON
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Credential | CRNA
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Telephone | 972-533-0098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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