Organization
LAKESIDE MED PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OM NEELEY (SOLE MEMBER)
(210) 338-6328
Entity
Organization
Contact information
Practice address
3619 PAESANOS PKWY STE 300, SAN ANTONIO, TX 78231-1263
(210) 338-6328
Mailing address
1141 NORTH LOOP 1604 EAST #105-PMB616, SAN ANTONIO, TX 78232-3624
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208M00000X
Hospitalist Physician
—
—
246ZC0007X
Surgical Assistant
—
—
Other
Enumeration date
05/30/2025
Last updated
07/11/2025
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