PAIN & NEUROMUSCULAR CLINIC OF TEXAS , P.A.
Medical Practice at Bandera Rd, San Antonio, TX

License number
Texas J7690
Category
Medical Practice
Type
Specialist
Owner
Name: DR. SAMUEL MICHAEL THEAGENE M.D.
Title: PRESIDENT
Phone: (210) 826-2311
Address
Address
6100 Bandera Rd, San Antonio, TX 78238
National Provider ID: 1275759540
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PAIN & NEUROMUSCULAR CLINIC OF TEXAS, PA

San Antonio, TX

Status:
Inactive
Doing business as:
North Irving Physical Medicine & Rehabilitation, PA<br>Pain & Neuromuscular Clinic of Texas, PA
Registration:
Dec 30, 1997
Addresses:
5018 San Pedro Ave, San Antonio, TX 78212 (Mailing)
7733 Louis Pasteur Dr, San Antonio, TX 78229
State ID:
0081872803
Business type:
Professional Association
President , Treasurer , Secretary , Director , Member , Vice-President:
Samuel M. Theagene President , Treasurer , Secretary , Director , Member , Vice-President, inactive
TIN:
32036006768

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