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LONGEVITY MEDICINE, PLLC
NPI 1962672204
General Practice in Boling, TX

Active since March 03, 2008
120 RAILROAD STREET, BOLING, TX 77420(979) 657-4000 Get Directions Write a Review

NPPES record last updated: March 3, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Longevity Medicine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONGEVITY MEDICINE, PLLC (NPI 1962672204) is a healthcare organization registered as a general practice in Boling, Texas and active in the NPI registry since March 2008. The organization lists Peter Erickson, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1962672204
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameLONGEVITY MEDICINE, PLLC
Location Address120 RAILROAD STREETBoling, TX 77420
Mailing AddressPo Box 700Boling, TX 77420-0700 · (979) 657-4400 · Fax (979) 657-3800
Phone(979) 657-4000
Organization SubpartNo
Authorized OfficialPeter EricksonPresident/ceo · (979) 657-4400
Enumeration DateMarch 3, 2008
✔ NPI 1962672204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in TX · E5746
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
120 RAILROAD STREET, Boling, TX 77420
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Other Identifiers 2

Medicare UPINB22558TX
Medicare PINE5746TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Longevity Medicine, PLLC's NPI number?

The NPI number for Longevity Medicine, PLLC is 1962672204. It was assigned to this organization in the NPPES registry on March 3, 2008.

Where is Longevity Medicine, PLLC located?

Longevity Medicine, PLLC is located at 120 Railroad Street, Boling, TX 77420. The listed phone number is (979) 657-4000.

What is Longevity Medicine, PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Longevity Medicine, PLLC was last updated on March 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.