MEMORIAL MEDICAL CENTER
NPI 1053964742
Clinic/Center - Rural Health in Port Lavaca, TX
NPI Status: Active since July 22, 2019
Contact Information
815 N VIRGINIA ST FL 2
PORT LAVACA, TX
ZIP 77979
Phone: (361) 552-0379
Fax: (361) 500-6904
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 45D0054055
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 04-11-2027
About MEMORIAL MEDICAL CENTER
This page provides the complete NPI Profile along with additional information for Memorial Medical Center, a primary care provider established in Port Lavaca, Texas operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1053964742 assigned on July 2019. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated one year ago. Memorial Medical Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's
- NPI
- 1053964742
- Provider Legal Name
- MEMORIAL MEDICAL CENTER
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 815 N VIRGINIA ST FL 2 PORT LAVACA, TX 77979
- Location Phone
- (361) 552-0379
- Location Fax
- (361) 500-6904
- Mailing Address
- 815 N VIRGINIA ST PORT LAVACA, TX 77979
- Mailing Phone
- (361) 552-0325
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 07-22-2019
- Last Update Date
- 09-19-2025
- Code Navigator
A primary care provider (PCP) like Memorial Medical Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rural Health
- Taxonomy Code
- 261QR1300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 3 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | |
| 4 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoice) + Vision + Adult Dental - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D0054055
- Facility Type
- Hospital
- Certificate Effective Date
- April 12, 2025
- Certificate Expiration Date
- April 11, 2027
- Laboratory Director
- BRYAN JANSSEN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Memorial Medical Center after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053964742, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053964742, enumerated as an "organization" on July 22, 2019.
The provider is located at 815 N VIRGINIA ST FL 2 PORT LAVACA, TX 77979 and the phone number is (361) 552-0379.
Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.
