Live Free Medical Clinic PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

J1258 Issued in TX

Legal business name

LIVE FREE MEDICAL CLINIC PLLC

Doing business as

Live Free Medical Clinic

Practice address

1312 Geneva St Ste B
Castroville, TX 78009-2941

Phone

(210) 580-4880

Fax

(830) 584-0409

NPI assigned

Aug 14, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jared Parker Hardin, MBA

Title

Operations Director

Phone

(210) 241-7990

Specialties & licenses 1

Addresses

Other names 1

• Live Free Medical Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1316427925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 GENEVA ST STE B",
            "city": "CASTROVILLE",
            "state": "TX",
            "postal_code": "780092941",
            "telephone_number": "210-580-4880",
            "fax_number": "830-584-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 GENEVA ST STE B",
            "city": "CASTROVILLE",
            "state": "TX",
            "postal_code": "780092941",
            "telephone_number": "210-580-4880",
            "fax_number": "830-584-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE FREE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "PARKER",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "210-241-7990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "J1258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Free Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ernest Conrad Kothmann, DC
• Lauren R. Krisch, P.T.
• Lori Ann Kurth, COTA
• Le Parc Safe Haven 2 LLC
• Leah M. Smith, PLLC Dba Steady North: Rebel Therapy
• Lloyd P Van Winkle, MD, PA (Medina Valley Family Practice)
• Lone Star Oral & Facial Surgery, PLLC
• Mindy Sheree Lucas, PT
• Christina Reyes Magana, LVN
• Lillian Susan Martinez, CNA,HHA,AAS,CPR

• Clinic/Center in Castroville, TX
• Providers in Castroville, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.