KILGORE LIFE CENTER
NPI 1093982290
Clinic/Center - Health Service in Kilgore, TX

Active since May 15, 2008
1711 S HENDERSON BLVD STE 300, KILGORE, TX 75662(903) 984-2145(903) 984-8361 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 2, 2025, Mar 19, 2025 (2 updates tracked since 2025).

About Kilgore Life Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KILGORE LIFE CENTER (NPI 1093982290) is a healthcare organization registered as a health service in Kilgore, Texas and active in the NPI registry since May 2008. The organization lists John D. Ford, President, as its authorized official.

NPPES Registry Identity

NPI1093982290
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameKILGORE LIFE CENTER
Location Address1711 S HENDERSON BLVD STE 300Kilgore, TX 75662-3563
Mailing Address4002 Technology CtrLongview, TX 75605-2697 · (903) 247-0484 · Fax (903) 247-0485
Fax(903) 984-8361
Organization SubpartYesParent: Phynet, Inc.
Authorized OfficialJohn D. FordPresident · (903) 247-0484
Enumeration DateMay 15, 2008
Last NPPES UpdateSeptember 2, 20252 updates tracked since enumeration
NPPES CertifiedMarch 19, 2025
NPI 1093982290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
1711 S HENDERSON BLVD STE 300, Kilgore, TX 75662

Other Names 1

Other NamePhynet, Inc.

Other Identifiers 1

Medicaid159694201TX

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1711 S HENDERSON BLVD STE 300
KILGORE, TX 75662
Nurse Practitioner (Family)
1711 S HENDERSON BLVD STE 300
KILGORE, TX 75662

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kilgore Life Center's NPI number?

The NPI number for Kilgore Life Center is 1093982290. It was assigned to this organization in the NPPES registry on May 15, 2008. The provider is also known as PhyNet, Inc..

Where is Kilgore Life Center located?

Kilgore Life Center is located at 1711 S Henderson Blvd Ste 300, Kilgore, TX 75662. The listed phone number is (903) 984-2145.

What is Kilgore Life Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Kilgore Life Center was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.