Organization
LONGEVITY CLINICAL LTC ASSOCIATES OF TEXAS, PLLC
Active
Organization
LONGEVITY CLINICAL LTC ASSOCIATES OF TEXAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE VINCUR (LWC PRACTICE MANAGER)
(561) 815-2427
Entity
Organization
Contact information
Practice address
8000 W IH 10 STE 600, SAN ANTONIO, TX 78230-3887
(561) 815-2427
Mailing address
11780 US HIGHWAY 1 STE N107, NORTH PALM BEACH, FL 33408-3007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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