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Organization
PORT LAVACA CLINIC ASSOCIATES PA
Active
Organization
PORT LAVACA CLINIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN LOYA (ADMINISTRATIVE ASSITANT)
(361) 553-6560
Entity
Organization
Contact information
Practice address
1200 NORTH VIRGINIA, PORT LAVACA, TX 77979-2507
(361) 552-6721
(361) 552-7463
Mailing address
1200 NORTH VIRGINIA, PORT LAVACA, TX 77979-2507
(361) 552-6721
(361) 552-7463
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133513504
—
TX
Enumeration date
06/13/2006
Last updated
02/27/2015
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