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Canyon Lake Medical Clinic

Rural Health Clinic/Center in Canyon Lake, TX · enumerated 2006 · authorized official Jeff Madison, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1124121009

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Registry record

Entity type Organization (Type 2)
Legal business name Canyon Lake Medical Clinic
Practice address 1356 Fm 2673, Canyon Lake, TX, 78133
Phone (830) 964-3019
Fax (830) 226-5002
Enumeration date Sep 6, 2006
Last updated in NPPES Aug 25, 2011

Taxonomy & classification

261QR1300X Rural Health Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Jeff Madison
Title Owner
Phone (512) 446-4500

Other identifiers

Identifier Type State Issuer
164301703 Medicaid TX -
0022HN Other TX BLUE CROSS/BLUE SHIELD
164301702 Medicaid TX -
164301701 Medicaid TX -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Canyon Lake Medical Clinic?
NPPES lists Jeff Madison (Owner) as the authorized official for this organization.
What is the NPI number for Canyon Lake Medical Clinic?
The NPI for Canyon Lake Medical Clinic is 1124121009, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-08-25.