| Longevity Medicine, Pllc | |
|
120 Railroad Street Boling TX 77420 | |
| (979) 657-4000 | |
| Not Available |
| Full Name | Longevity Medicine, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 120 Railroad Street, Boling, Texas |
| Authorized Official Name and Position | Peter Erickson (PRESIDENT/CEO) |
| Authorized Official Contact | 9796574400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Medicine, Pllc Po Box 700 Boling TX 77420-0700 Ph: (979) 657-4400 | Longevity Medicine, Pllc 120 Railroad Street Boling TX 77420 Ph: (979) 657-4000 |
| NPI Number | 1962672204 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 03/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962672204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | E5746 (Texas) | Primary |
Mid Coast Well Care - Boling Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10555 Fm 1301 Rd, Boling, TX 77420 Phone: 979-543-5510 |