NPIMap

Organization Active NPI

Ageless Men's Health, PLLC

  • Specialist
  • Houston, TX
National Provider Identifier
1790038875
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
AGELESS MEN'S HEALTH, PLLC
Practice address
9652 Katy Fwy
Houston, TX 77055-6322
Phone
(713) 464-6800
Fax
(713) 464-6804
NPI assigned
Oct 26, 2012
Last updated
Oct 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
AGELESS MEN'S HEALTH HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Authorized official

Name
Mrs. Melissa C. McClellan
Title
VP of Operations
Phone
(901) 757-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

9652 Katy Fwy
Houston, TX 77055-6322

Mailing address

9652 Katy Fwy
Houston, TX 77055-6322
Phone (713) 464-6800

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health PLLC3 organizations share this tax ID, including this one
Part of
Ageless Men's Health Holdings LLC

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1790038875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9652 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770556322",
            "telephone_number": "713-464-6800",
            "fax_number": "713-464-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9652 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770556322",
            "telephone_number": "713-464-6800",
            "fax_number": "713-464-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AGELESS MEN'S HEALTH HOLDINGS, LLC",
        "enumeration_date": "2012-10-26",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "901-757-3643",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.