# CITIZENS MEDICAL CENTER COUNTY OF VICTORIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** PORT LAVACA NURSING AND REHABILITATION CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144641234
- **Authorized official:** MR. MICHAEL OLSON (CEO/ADMINISTRATOR)
- **Authorized official phone:** (361) 573-9181

## Contact information

- **Practice address:** 524 VILLAGE RD, PORT LAVACA, TX 77979-2380
- **Practice address phone:** (361) 552-3741
- **Practice address fax:** (361) 552-5808
- **Mailing address:** 2701 HOSPITAL DR, VICTORIA, TX 77901-5748
- **Mailing address phone:** (361) 573-9181
- **Mailing address fax:** (361) 572-5126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2013
- **Last updated:** 05/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001025710 | — | TX |
| 05 | — | 362007201 | — | TX |
| 05 | — | 4259 | — | TX |