Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Memorial Medical Center

Organization Family Medicine Physician · NPI 1053964742

Memorial Medical Center is a Family Medicine Physician in Port Lavaca, Texas. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
5
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Practice location Address checks out

815 N Virginia St Fl 2
Port Lavaca, TX 77979-3025
Phone: (361) 552-0379
Fax: (361) 500-6904
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X
Family Medicine Physician Taxonomy 207Q00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
General Practice Physician Taxonomy 208D00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1053964742
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMemorial Medical Center
Authorized official Erin Clevenger — Ceo · (361) 552-6713
Other names Memorial Medical Clinic Hospital Campus; Memorial Medical Clinic Hospital Campus
NPI enumeratedJuly 22, 2019
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025
Mailing address815 N Virginia St, Port Lavaca, TX 77979-3025

Other providers in Port Lavaca