Individual
AGNA ELIZABETH BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
101 CROWN POINTE BLVD STE 200, WILLOW PARK, TX 76087-1191
(817) 599-7661
(817) 599-8408
Mailing address
101 CROWN POINTE BLVD STE 200, WILLOW PARK, TX 76087-1191
(817) 599-7661
(817) 599-8408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L5037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1731663001
—
TX
05
—
173166303
—
TX
01
—
7276626
AETNA
—
01
—
8EU779
BCBS
TX
Enumeration date
07/01/2005
Last updated
03/09/2022
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