Organization · Type 2 NPI
Longevity Medicine, PLLC
General Practice Physician · Boling, TX
NPI number
1962672204
Active
Practice location
120 Railroad Street
Boling, TX 77420
Mailing address
PO Box 700
Boling, TX 77420-0700
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | E5746 (TX) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1962672204
Longevity Medicine, PLLC's National Provider Identifier is 1962672204, issued on Mar 3, 2008. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Boling, TX. The record was last updated on Mar 3, 2008.