Organization
ANTI AGING CENTER OF TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSIER MARIANO NISNISAN M.D. (CEO/PRESIDENT)
(281) 759-6437
Entity
Organization
Contact information
Practice address
1400 CREEKWAY DRIVE, STE 201A, SUGARLAND, TX 77478-4073
(281) 759-6437
(281) 759-6447
Mailing address
1400 CREEKWAY DRIVE, STE 201A, SUGARLAND, TX 77478-4073
(281) 759-6437
(281) 759-6447
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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