Longevity Wellness Center
LBN: Longevity Wellness Group
Longevity Wellness Center is an health care organization with primary practice located at 4101 Marathon Boulevard , Austin TX 78756-4026. The organization recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Internist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Longevity Wellness Group can be contacted via phone (512) 323-9222, or through Davis, Gregory Trent via phone (512) 323-9222.
Contact Information
Primary practice address
4101 Marathon Boulevard
Austin TX 78756-4026
Phone: (512) 323-9222
Fax: (512) 323-9232
Website:
Authorized official contact:
Name: Davis, Gregory Trent Doctor of Medicine (MD)
Phone: (512) 323-9222
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Internist | 111NI0900X | DC30474 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | Texas |
Profile Details
| NPI number | 1538314562 |
|---|---|
| LBN Legal business name | Longevity Wellness Group |
| DBA Doing business as | Longevity Wellness Center |
| Authorized official | Davis, Gregory Trent Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 18th, 2008 |
| Last updated | Apr 15th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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