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CANYON LAKE MEDICAL CLINIC
NPI 1124121009
Clinic/Center - Rural Health in Canyon Lake, TX

Active since September 06, 2006
1356 FM 2673, CANYON LAKE, TX 78133(830) 964-3019(830) 226-5002 Get Directions Write a Review

NPPES record last updated: August 25, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Canyon Lake Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANYON LAKE MEDICAL CLINIC (NPI 1124121009) is a healthcare organization registered as a rural health in Canyon Lake, Texas and active in the NPI registry since September 2006. The organization lists Jeff P Madison, Owner, as its authorized official.

NPPES Registry Identity

NPI1124121009
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCANYON LAKE MEDICAL CLINIC
Location Address1356 FM 2673Canyon Lake, TX 78133-4510
Mailing Address1356 Fm 2673Canyon Lake, TX 78133-4510 · (830) 964-3019 · Fax (830) 226-5002
Phone(830) 964-3019
Fax(830) 226-5002
Organization SubpartNo
Authorized OfficialJeff P MadisonOwner · (512) 446-4500
Enumeration DateSeptember 6, 2006
Last NPPES UpdateAugust 25, 2011
✔ NPI 1124121009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1356 FM 2673, Canyon Lake, TX 78133
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Other Identifiers 5

Medicaid164301701TX
Medicaid164301702TX
Other0022HNTX · Blue Cross/blue Shield
Medicaid164301703TX
Medicare OSCAR/certification67-3878

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INGRID ANNE THIES PT
Physical Therapist
1356 FM 2673
CANYON LAKE, TX 78133
Comal County (830) 907-2145
PHYSICAL THERAPY UNLIMITED, P.C.
Physical Therapist
1356 FM 2673
CANYON LAKE, TX 78133
Comal County (830) 907-2145
ROBERT RODRIGUEZ L.P.T.
Physical Therapist
1356 FM 2673
CANYON LAKE, TX 78133
Comal County (830) 907-2145

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Canyon Lake Medical Clinic's NPI number?

The NPI number for Canyon Lake Medical Clinic is 1124121009. It was assigned to this organization in the NPPES registry on September 6, 2006.

Where is Canyon Lake Medical Clinic located?

Canyon Lake Medical Clinic is located at 1356 Fm 2673, Canyon Lake, TX 78133. The listed phone number is (830) 964-3019.

What is Canyon Lake Medical Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Canyon Lake Medical Clinic was last updated on August 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.