MEMORIAL MEDICAL CENTER NPI 1497153589

NPI Information

  • NPI: 1497153589
  • Provider Name: MEMORIAL MEDICAL CENTER
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: MEMORIAL MEDICAL CLINIC
  • Address: 1016 N VIRGINIA ST
    PORT LAVACA, TX
    ZIP 77979
  • Phone: (361) 552-0325

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NPI Details

MEMORIAL MEDICAL CENTER is a rural health clinic center in Port Lavaca, TX. MEMORIAL MEDICAL CENTER NPI is 1497153589. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Memorial Medical Clinic.

The provider's business location address is:

1016 N VIRGINIA ST
PORT LAVACA, TX
ZIP 77979-000
Phone: (361) 552-0325
Fax: (361) 500-6904

The provider's authorized official is Erin Clevenger .
The authorized official title is Ceo and has the following contact phone number (361) 552-6713.

The enumeration date for this NPI number is 12/5/2014 and was last updated on 10/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineTEXASNo
2207R00000XInternal MedicineTEXASNo
3207V00000XObstetrics & GynecologyTEXASNo
4208000000XPediatricsNo
5261QR1300XClinic/CenterRural HealthTEXASYes
6363LF0000XNurse PractitionerFamilyTEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1137909112MEDICAIDTEXAS
2673422OTHERTEXASMEDICARE RHC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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