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Organization
KATHLEEN JANE LYSSY MD PA
Active
Organization
KATHLEEN JANE LYSSY MD PA
Active
Other names
Dr. Kathleen Jane Lyssy MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA K SOUHRADA (OFFICE MANAGER)
(210) 256-9500
Entity
Organization
Contact information
Practice address
6100 BANDERA ROAD, SUITE 403, SAN ANTONIO, TX 78238-1653
(210) 256-9500
(210) 256-8720
Mailing address
6100 BANDERA ROAD, SUITE 403, SAN ANTONIO, TX 78238-1653
(210) 256-9500
(210) 256-8720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Z061
MEDICARE GROUP PTAN
TX
Enumeration date
06/06/2007
Last updated
07/02/2008
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