NPI age
18 years
Enumerated 2008-05-19
● Active Type 2 · Organization
Subpart
Phynet, Inc
Phynet, Inc is 1 of 674 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Ford
President
Last NPPES update
2025-03-19
Source: monthly bulk 2026-05
How this organization compares
Across 674 active clinic/center providers in Texas.
NPI age
18 years
↑ 7 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-05Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
219 N Polk St
Jefferson, TX 756572131
Mailing address
4002 Technology Ctr
Longview, TX 756052697
Authorized official
John D. Ford
President
📞 9032470484
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Robin Gale, PNP Nurse Practitioner NPI 1700870185
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 159694201 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Jefferson Life Center
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Phynet Inc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.