Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LONGEVITY WELLNESS GROUP
Active
Organization
LONGEVITY WELLNESS GROUP
Active
Other names
Longevity Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY TRENT DAVIS M.D. (CEO)
(512) 323-9222
Entity
Organization
Contact information
Practice address
4101 MARATHON BOULEVARD, AUSTIN, TX 78756-4026
(512) 323-9222
(512) 323-9232
Mailing address
PO BOX 303460, AUSTIN, TX 78703-0058
(512) 323-9222
(512) 323-9232
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
DC30474
TX
207R00000X
Internal Medicine Physician
Primary
—
TX
Other
Enumeration date
11/18/2008
Last updated
04/15/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up