KENNETH M. LYSSY JR MD PA (NPI# 1205039559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205039559 |
| Entity Type | Organization |
| Organization Name | KENNETH M. LYSSY JR MD PA |
| Other Organization Name | DR KENNETH M LYSSY JR MD |
| Practice Address |
6100 Bandera Rd Suite 403 San Antonio TX 78238-1652 |
| Mailing Address |
6100 Bandera # 403 San Antonio TX 78238-1653 |
| Practice Telephone | 2102569500 |
| Practice Fax Number | 2102568720 |
| Mailing Telephone | 2102569500 |
| Mailing Fax Number | 2102568720 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2008-07-02 |
| Authorized Official Name | MRS. MELISSA SOUHRADA (OFFICE MANAGER) |
| Authorized Official Telephone | 2102569500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE INDIVIDUAL PTAN | 00Z062 | 01 |
| TX | MEDICARE GROUP PTAN | 00Z062 | 01 |
| Other Name | Type Code |
|---|---|
| Dr Kenneth M Lyssy Jr MD | Other Name - Individual/Organization |
| Street Address |
6100 BANDERA RD SUITE 403 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78238-1652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831182005 | Kathleen Jane Lyssy | Internal Medicine | 6100 Bandera Rd, 403, San Antonio, TX 78238-1652 | 2005-08-23 |
| 1275759540 | Pain & Neuromuscular Clinic of Texas, P.a. | Specialist | 6100 Bandera Rd, 710, San Antonio, TX 78238-1652 | 2007-04-17 |
| 1316061377 | Carlos Javier Diaz Velez | Internal Medicine | 6100 Bandera Rd, Suite 215, San Antonio, TX 78238-1652 | 2007-03-16 |
| 1417086372 | Lawrence Paul Dimiceli | Dentist | 6100 Bandera Rd, Ste 300, San Antonio, TX 78238 | 2007-03-05 |
| 1831284892 | Praful R Mehta | Internal Medicine | 6100 Bandera Rd, Suite 710, San Antonio, TX 78238-1652 | 2006-10-04 |
| 1194718361 | Kenneth M Lyssy Jr. | Family Medicine | 6100 Bandera Rd, 403, San Antonio, TX 78238-1652 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598383259 | Dialysis Clinic Inc. | Clinic/Center | 6146 Wurzbach Road, San Antonio, TX 78238 | 2020-07-09 |
| 1043857360 | Danielle Renee De Luna | Counselor | 5505 Lost Lane, San Antonio, TX 78238 | 2019-12-05 |
| 1013444777 | Avery Rodriguez | Physical Therapy Assistant | 5270 Bandera Rd Ste 14, San Antonio, TX 78238 | 2017-05-12 |
| 1760898894 | Silas Pimentel | Physical Therapist | 5720 Bandera Rd Ste 14, San Antonio, TX 78238 | 2014-07-09 |
| 1942550553 | Stanley Toh Forze | Registered Nurse | 6933 Border Brk Apt 1910, San Antonio, TX 78238 | 2012-09-12 |
| 1891004032 | Texan Smile Dentistry 3 PC | Dentist | 5983 Bandera Rd., San Antonio, TX 78238 | 2010-10-06 |
| 1275847683 | Deborah Michelle Solorzano | Dentist | 5715 Evers Road, San Antonio, TX 78238 | 2010-07-28 |
| 1932436326 | Campos Family Dental, P.C. | Dentist | 6140 Wurzbach Road, San Antonio, TX 78238 | 2009-11-06 |
| 1063665495 | Benjamino L Granato | Durable Medical Equipment & Medical Supplies | 6415 Bandera, San Antonio, TX 78238 | 2008-10-29 |
| 1891962262 | Gerald L Froemming | Dentist | 6436 Bandera Road, #1, San Antonio, TX 78238 | 2008-05-14 |
| Find all providers in zip 78238 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295327 | Courtney L Buchmeier | Family Medicine | 16620 San Pedro Ave, San Antonio, TX 78232-2327 | 2020-11-02 |
| 1255938866 | Bart Knight | Family Medicine | 106 Herweck Dr, San Antonio, TX 78213-3329 | 2020-10-06 |
| 1114530565 | Jacob C Reedy | Family Medicine | 525 Richmond Ave, San Antonio, TX 78215-2008 | 2020-08-26 |
| 1750992277 | Premier Tests LLC | Family Medicine | 410 E Wildwood, San Antonio, TX 78212-1758 | 2020-08-10 |
| 1770104457 | Bryanna Bermea Cantu | Family Medicine | 2318 San Pedro Ave Ste 12, San Antonio, TX 78212-1901 | 2020-05-04 |
| 1447886544 | Lets Look At Your Labs LLC | Family Medicine | 1603 Babcock Rd Ste 238-5, San Antonio, TX 78229-4708 | 2020-03-20 |
| 1609414937 | Lonestar Visiting Physicians LLC | Family Medicine | 406 Halliday Ave, San Antonio, TX 78210-4057 | 2019-12-17 |
| 1679126817 | Sarah Heather Martinez | Family Medicine | 15106 Oak Loft St, San Antonio, TX 78232-4617 | 2019-07-17 |
| 1659930634 | Villa Family Clinic, PC | Family Medicine | 2000 Se Loop 410 Ste 127a, San Antonio, TX 78220-4933 | 2019-06-12 |
| 1508327859 | South Texas Family Medicine and Urgent Care Center | Family Medicine | 3526 Galveston Trl, San Antonio, TX 78253-6219 | 2019-03-28 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78238 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.