Organization
MEMORIAL MEDICAL CENTER
Active
Organization
MEMORIAL MEDICAL CENTER
Active
Parent organization
MEMORIAL MEDICAL CENTER
Other names
Memorial Medical Clinic Hospital Campus
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL MEDICAL CENTER
Authorized official
ERIN CLEVENGER (CEO)
(361) 552-6713
Entity
Organization
Contact information
Practice address
815 N VIRGINIA ST FL 2, PORT LAVACA, TX 77979-3025
(361) 552-0379
(361) 500-6904
Mailing address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(361) 552-0325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208D00000X
General Practice Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/22/2019
Last updated
09/19/2025
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