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General NPI Number Information
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NPI Number | 1437861291
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Entity Type | Organization
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Legal Business Name | AGNS CORP
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 279 N INTERSTATE 35 E
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City | DESOTO
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State | TX
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Zip | 75115-5299
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Country | US
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Telephone | 469-747-3030
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Fax | 469-747-3038
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Provider Business Mailing Address
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Address Line | 279 N INTERSTATE 35 E
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City | DESOTO
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State | TX
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Zip | 75115-5299
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Country | US
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Telephone | 469-747-3030
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Fax | 469-747-3038
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | AMIRAH BOYO
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Credential | LMT, MMP
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Telephone | 469-747-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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