Provider Demographics
NPI:1487268587
Name:AGAPE FOOT CARE PA
Entity type:Organization
Organization Name:AGAPE FOOT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-210-2911
Mailing Address - Street 1:1312 14TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6206
Mailing Address - Country:US
Mailing Address - Phone:972-248-3191
Mailing Address - Fax:972-248-3198
Practice Address - Street 1:5584 N SHILOH RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6614
Practice Address - Country:US
Practice Address - Phone:214-210-2911
Practice Address - Fax:214-210-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty