Healthcare Provider Details

I. General information

NPI: 1467987610
Provider Name (Legal Business Name): SLP KNOX CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S AVENUE F
KNOX CITY TX
79529-2103
US

IV. Provider business mailing address

605 S AVENUE F
KNOX CITY TX
79529-2103
US

V. Phone/Fax

Practice location:
  • Phone: 940-658-3543
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: RICHARD AGNEW
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 512-565-6159