| Agape Family Practice LLC | |
|
1519 S Jackson Rd Ste 2 Pharr TX 78577-6614 | |
| (956) 269-9764 | |
| Not Available |
| Full Name | Agape Family Practice LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1519 S Jackson Rd Ste 2, Pharr, Texas |
| Authorized Official Name and Position | Kimberly Belgum (CLINIC OWNER/PROVIDER) |
| Authorized Official Contact | 9562699764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Family Practice LLC 1519 S Jackson Rd Ste 2 Pharr TX 78577-6614 Ph: (956) 269-9764 | Agape Family Practice LLC 1519 S Jackson Rd Ste 2 Pharr TX 78577-6614 Ph: (956) 269-9764 |
| NPI Number | 1699411389 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 07/21/2022 |
| Certification Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4183002801 |
|---|---|
| Medicare Enrollment ID | O20220608000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699411389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Kimberly M Belgum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083258552 PECOS PAC ID: 0749613610 Enrollment ID: I20191206000744 |
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