Provider Demographics
NPI:1790175230
Name:LYSA L CURRY MD PA
Entity Type:Organization
Organization Name:LYSA L CURRY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-392-2964
Mailing Address - Street 1:PO BOX 29521
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-0521
Mailing Address - Country:US
Mailing Address - Phone:210-392-2964
Mailing Address - Fax:210-651-7321
Practice Address - Street 1:23519 OSCEOLA BLF
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2625
Practice Address - Country:US
Practice Address - Phone:210-392-2964
Practice Address - Fax:210-651-7321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G02946Medicare UPIN
TX8J9357Medicare PIN