Organization
REPUBLIC LONGEVITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENA GASKIN (COO)
(979) 229-9188
Entity
Organization
Contact information
Practice address
3201 UNIVERSITY DR E STE 370, BRYAN, TX 77802-3485
(979) 703-1426
Mailing address
10592 COUNTY ROAD 175, IOLA, TX 77861-3617
(979) 703-1426
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
06/26/2026
Last updated
06/26/2026
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