MEMORIAL MEDICAL CLINIC (NPI# 1578960647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578960647 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CLINIC |
| Practice Address |
815 N Virginia St Port Lavaca TX 77979-3025 |
| Practice Telephone | 3615520224 |
| Practice Fax Number | 3615520220 |
| Mailing Telephone | 3615520224 |
| Mailing Fax Number | 3615520220 |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |
| Authorized Official Name | DIANE CHRIS MOORE (CFO) |
| Authorized Official Telephone | 3615520224 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
000487 | TX | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 137909111 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639510092 | Memorial Medical Clinic | Family Medicine | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2013-07-15 |
| Street Address |
815 N VIRGINIA ST |
| City | PORT LAVACA |
| State | TX |
| Zip Code | 77979-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609870161 | William J Crowley IIi | Family Medicine | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2005-06-11 |
| 1134776545 | Kristi Boyd | Nurse Practitioner | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2019-08-20 |
| 1053964742 | Memorial Medical Center | Orthopaedic Surgery | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2019-07-22 |
| 1750811733 | Penny Goulden | Physical Therapist | 815 N Virginia St, Port Lavaca, TX 77979 | 2017-06-13 |
| 1922546936 | Ess of Port Lavaca LLC | Emergency Medicine | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2017-02-09 |
| 1669857157 | Traci Shefcik | Nurse Practitioner | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2015-07-24 |
| 1073997524 | Courtne Thurlkill | Nurse Practitioner | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2015-07-15 |
| 1104203181 | Memorial Medical Center | Surgery | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2015-04-29 |
| 1366866477 | Victoria Professional Medical Consultants, LLC | Emergency Medicine | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2014-02-10 |
| 1639510092 | Memorial Medical Clinic | Family Medicine | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2013-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719836 | Memorial Medical Center | Nursing Care | 118 Trinity Shores Drive, Port Lavaca, TX 77979 | 2019-09-18 |
| 1972083475 | Kelly Leigh Meyer | Occupational Therapy Assistant | Port Lavaca Nursing and Rehabilitation Center, 524 Village Rd, Port Lavaca, TX 77979 | 2018-08-15 |
| 1679943393 | Vrinda Mohunta | Dentist | 204 Tx-35, Port Lavaca, TX 77979 | 2015-10-07 |
| 1770999344 | Smile Experts Pllc | Dentist | 204 State Hwy 35 South, Port Lavaca, TX 77979 | 2014-07-03 |
| 1083927636 | Calhoun Home Health, LLC | Home Health | 1300 N Virginia St Ste 111, Port Lavaca, TX 77979 | 2010-07-23 |
| 1740423490 | Diana E. Garcia | Case Manager/Care Coordinator | 3272 U.S. Hwy 87, Port Lavaca, TX 77979 | 2009-04-10 |
| 1982844940 | Gillian V. Kwi | Dentist | 1112 Half League Rd, Port Lavaca, TX 77979 | 2009-03-03 |
| 1003054057 | Ngale Ndiva Mongoh | Pharmacist | 325 S. Hwy. 35 By Pass, Port Lavaca, TX 77979 | 2009-01-29 |
| 1326248592 | Nichole Lynn Bruno | Nurse Practitioner | 1300 N. Virginia Street, Port Lavaca, TX 77979 | 2007-07-24 |
| 1518168855 | Calhoun County Senior Citizens Assoc. Inc. | Home Delivered Meals | 2104 W Austin St., Port Lavaca, TX 77979 | 2007-05-31 |
| Find all providers in zip 77979 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689630865 | Memorial Medical Center | General Acute Care Hospital | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629514203 | Tmc Bonham Hospital | General Acute Care Hospital | 504 Lispcomb Blvd, Bonham, TX 75418 | 2017-01-06 |
| 1164772216 | Methodist West Houston Hospital | General Acute Care Hospital | 5807 Grand Saline Dr, Richmond, TX 77469-6173 | 2012-09-17 |
| 1528367356 | Liberty County Hospital District No 1 | General Acute Care Hospital | 1353 N Travis, Liberty, TX 77575-3549 | 2011-03-18 |
| 1669613105 | Kingsbrook Jewish Medical Center | General Acute Care Hospital | 1404 Savoy Ct, Colleyville, TX 76034-6267 | 2009-03-12 |
| 1578724811 | Vaishali Kawaduji Bhusari | General Acute Care Hospital | 4555 Lorraine Ave, Dallas, TX 75205-3612 | 2008-06-19 |
| 1548457682 | Audie Murphy Va Hospital | General Acute Care Hospital | 4041 Merton Minter, San Antonio, TX 78229 | 2007-10-03 |
| 1033309323 | George Daniel Williamson | General Acute Care Hospital | 5087 E State Highway 22, Hamilton, TX 76531-1355 | 2007-08-01 |
| 1396861324 | Dr. Carlos F. Morales Md. | General Acute Care Hospital | 4414 Centerview Dr., Ste 168, San Antonio, TX 78228-1404 | 2007-03-21 |
| 1780786699 | Palacios Community Medical Center | General Acute Care Hospital | 311 Green Ave, Palacios, TX 77465-3213 | 2006-09-01 |
| 1033229778 | Va Hospital | General Acute Care Hospital | 8222 Lone Bridge Ln, Humble, TX 77338-1726 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
| City | PORT LAVACA |
| Zip Code | 77979 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.