Memorial Medical Clinic

LBN: Memorial Medical Clinic
Memorial Medical Clinic is an health care organization with primary practice located at 815 N Virginia St , Port Lavaca TX 77979-3025. The organization recently has only one registered license in Hospitals / Critical Access, which is considered as the primary health care specialty. Memorial Medical Clinic can be contacted via phone (361) 552-0224, or through Moore, Diane Chris via phone (361) 552-0224.

Contact Information

Primary practice address
815 N Virginia St Port Lavaca TX 77979-3025
Phone: (361) 552-0224
Fax: (361) 552-0220
Website:
Map and Directions
Authorized official contact:
Name: Moore, Diane Chris
Phone: (361) 552-0224

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Critical Access 282NC0060X 000487 Texas

Profile Details

NPI number 1578960647
LBN Legal business name Memorial Medical Clinic
DBA Doing business as
Authorized official Moore, Diane Chris
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2014
Last updated Dec 4th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578960647 NPPES
Texas MEDICAID 137909111

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