MEDICARE: SOUTH PLAINS PUBLIC HEALTH DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	C7676	TX

General Provider Information

NPI Number	:	1750339339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH PLAINS PUBLIC HEALTH DISTRICT

Provider Business Mailing Address
First Line	:	415 MUSTANG DR
Second Line	:	P.O. BOX 315
City	:	DENVER CITY
State	:	TX
Zip	:	79323-2749
Country	:	US
Telephone Number	:	806-592-2706
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 MUSTANG DR
Second Line	:
City	:	DENVER CITY
State	:	TX
Zip	:	79323-2749
Country	:	US
Telephone Number	:	806-592-2706
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MORRIS SALEM KNOX
Credential	:	M.D.
Telephone Number	:	806-592-2706

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

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