Clare Horadam, PTA
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Port Lavaca, TX
NPI 1225518798 · NPPES record last updated Aug 15, 2018
Key facts
- NPI
- 1225518798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 2089610 (TX)
- Practice address
- 524 Village Rd
Port Lavaca, TX 77979-2380 - Phone
- (361) 552-3741
- NPI assigned
- Aug 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2089610 | TX | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 2089610 | TX | Yes |
Addresses
Primary practice location
524 Village Rd
Port Lavaca, TX 77979-2380
Mailing address
524 Village Rd
Port Lavaca, TX 77979-2380
Other providers in Port Lavaca, TX
- Gulf Coast Foot Clinic PA
- Adrianne Gutierrez
- H-E-B, LP
- Jaclyn Hartl
- Diana Hoover
- Mabel Allene Hunt
- Destiny Ibrom
- Joseph Dillon Jenkins
- Kestler Chiropractic Clinic,LLC
- Bryan Claude Kestler
All providers in Port Lavaca, TX · Physical Medicine & Rehabilitation Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.