Pain & Neuromuscular Clinic of Texas , P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

J7690 Issued in TX

Legal business name

PAIN & NEUROMUSCULAR CLINIC OF TEXAS , P.A.

Practice address

6100 Bandera Rd
710
San Antonio, TX 78238-1652

Phone

(210) 826-2311

Fax

(210) 826-2641

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Michael Theagene, M.D.NPI 1518928167

Title

President

Phone

(210) 826-2311

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Michael Theagene, MD

  • Physical Medicine & Rehabilitation Physician
  • Laurelton, NY
  • NPI 1518928167
  NPD (past) Authorized official
• Roger M Moczygemba, MD

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1750382503
  NPD (past)
• Vicki J Sparks, MD

  • General Practice Physician
  • San Antonio, TX
  • NPI 1265536254
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275759540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29097",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782290097",
            "telephone_number": "210-826-2311",
            "fax_number": "210-826-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 BANDERA RD",
            "address_2": "710",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381652",
            "telephone_number": "210-826-2311",
            "fax_number": "210-826-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN & NEUROMUSCULAR CLINIC OF TEXAS , P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THEAGENE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-826-2311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J7690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0074DJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demi Asvestas Pai, CNM
• Sha'Keithra Labrijayte' Paige-Lott, MS, BCBA
• Courtney Paige, LCSW
• Shawnya Evette Paige
• Sheeba R. Paily, MD
• Pain & Recovery Clinic of San Antonio
• Pain Management Enterprises, LLC
• Pain Management Specialists
• Pain Specialty Consultants, PA
• James Paine, M.D.

• Specialist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.