NPI age
19 years
Enumerated 2007-04-17
● Active Type 2 · Organization
Pain & Neuromuscular Clinic Of Texas , P.A.
Pain & Neuromuscular Clinic Of Texas , P.A. is 1 of 4038 specialist organizations in Texas.
Primary specialty
Specialist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Theagene
President
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 4038 active specialist providers in Texas.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-04Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
6100 Bandera Rd, 710
San Antonio, TX 782381652
Mailing address
Po Box 29097
San Antonio, TX 782290097
Authorized official
Samuel Michael Theagene, M.D.
President
📞 2108262311
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Lawrence Dimiceli, DDS Dentist NPI 1417086372
- Kathleen Lyssy, M.D. Internal Medicine NPI 1831182005
- Kenneth Lyssy, M.D. Family Medicine NPI 1194718361
- Praful Mehta, M.D. Internal Medicine NPI 1831284892
Specialties
-
Specialist PrimaryAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0074DJ | BLUE CROSS BLUE SHIELD |
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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