Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MEMORIAL MEDICAL CENTER
NPI 1104203181
Surgery in Port Lavaca, TX

Active since April 29, 2015
815 N VIRGINIA ST, PORT LAVACA, TX 77979(361) 552-6713(361) 552-0220 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 6, 2026, Mar 4, 2026 (2 updates tracked since 2026).

  • Organization
  • Surgery
  • Accepts Insurance

About MEMORIAL MEDICAL CENTER

This page provides the complete NPI Profile along with additional information for Memorial Medical Center, a provider established in Port Lavaca, Texas operating as a Surgery. The healthcare provider is registered in the NPI registry with number 1104203181 assigned on April 2015. The practitioner's primary taxonomy code is 208600000X. The provider is registered as an organization and their NPI record was last updated July 2026. Memorial Medical Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Erin Clevenger (Ceo)

NPI
1104203181 Verify this NPI
Provider Name
MEMORIAL MEDICAL CENTER
Entity Type
Organization
Location Address
815 N VIRGINIA ST PORT LAVACA, TX 77979
Location Phone
(361) 552-6713
Location Fax
(361) 552-0220
Mailing Address
815 N VIRGINIA ST PORT LAVACA, TX 77979
Mailing Phone
(361) 552-6713
Mailing Fax
(361) 552-0220
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-29-2015
Last Update Date
07-06-2026
Code Navigator

A surgeon like Memorial Medical Center treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

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

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

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:

  • 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
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ERIN CLEVENGER

Authorized Official Title
CEO
Authorized Official Phone
(361) 552-0454

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
T225OTHER (01)TXMEDICARE PART B
137909103MEDICAID (05)TX 

Reviews for MEMORIAL MEDICAL CENTER

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Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Podiatrist (Foot Surgery)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Podiatrist (Foot Surgery)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Podiatrist
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Anesthesiology
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Obstetrics & Gynecology
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Family Medicine
815 N VIRGINIA ST
PORT LAVACA, TX 77979
General Acute Care Hospital (Critical Access)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Emergency Medicine
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Emergency Medicine
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Emergency Medicine
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Physical Therapist
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Practitioner (Family)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Radiology (Diagnostic Radiology)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
General Acute Care Hospital (Critical Access)
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Anesthetist, Certified Registered
815 N VIRGINIA ST
PORT LAVACA, TX 77979

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104203181, enumerated as an "organization" on April 29, 2015.

The provider is located at 815 N VIRGINIA ST PORT LAVACA, TX 77979 and the phone number is (361) 552-6713.

Surgery with taxonomy code 208600000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Medicare and. Please consult your insurance carrier or call the provider to verify.