| Longevity & Wellness Center Of South Texas | |
|
1329 Broadway St Rockport TX 78382-3333 | |
| (361) 727-9768 | |
| (361) 727-9783 |
| Full Name | Longevity & Wellness Center Of South Texas |
|---|---|
| Speciality | Internal Medicine |
| Location | 1329 Broadway St, Rockport, Texas |
| Authorized Official Name and Position | Albert Lee Guinn (PRESIDENT) |
| Authorized Official Contact | 3612250800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity & Wellness Center Of South Texas 1329 Broadway St Rockport TX 78382-3333 Ph: (361) 727-9768 | Longevity & Wellness Center Of South Texas 1329 Broadway St Rockport TX 78382-3333 Ph: (361) 727-9768 |
| NPI Number | 1558402495 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 10/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558402495 | NPI | - | NPPES |
| 008259N | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E8529 (Texas) | Secondary |
| 207R00000X | Internal Medicine | E8529 (Texas) | Primary |
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