NPIMap

Organization Active NPI

Ageless Men's Health Holdings, Inc

Doing business as Ageless Men's Health

  • Family Medicine Physician
  • Georgetown, TX
National Provider Identifier
1013789973
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AGELESS MEN'S HEALTH HOLDINGS, INC
Doing business as
Ageless Men's Health
Practice address
950 W University Ave Ste 102
Georgetown, TX 78626-6505
Phone
(512) 250-5300
NPI assigned
Oct 24, 2023
Last updated
Nov 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Wilkinson
Title
Business Operations Director
Phone
(702) 818-0446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

950 W University Ave Ste 102
Georgetown, TX 78626-6505

Mailing address

950 W University Ave Ste 102
Georgetown, TX 78626-6505

Other names 1

  • Ageless Men's Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

950 W University Ave
Ste 102
Georgetown, TX 78626
Phone (512) 240-5682

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1013789973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W UNIVERSITY AVE STE 102",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W UNIVERSITY AVE STE 102",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266505",
            "telephone_number": "512-250-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "702-818-0446"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageless Men's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.