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PREMISE HEALTH OF TEXAS MEDICAL P.A NPI 1831771518


NPI Information

NPI: 1831771518
Provider Name: PREMISE HEALTH OF TEXAS MEDICAL, P.A

Doing Business As: FUJI DIOSYNTH BIOTECHNOLOGIES HEALTH CENTER

Classification: Clinic/Center - 261QX0100X
Entity Type: Organization

Specialization: Occupational Medicine

CLIA Number: 45D2219381

Address:
8872 HSC PKWY RM 106
BRYAN, TX
ZIP 77807
Phone: (979) 431-3682
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PREMISE HEALTH OF TEXAS MEDICAL, P.A is an occupational medicine clinic center in Bryan, TX. PREMISE HEALTH OF TEXAS MEDICAL, P.A NPI is 1831771518. The provider is registered as an organization entity type.
The provider Is Doing Business As Fuji Diosynth Biotechnologies Health Center.

The provider's business location address is:

8872 HSC PKWY RM 106
BRYAN, TX
ZIP 77807-107
Phone: (979) 431-3682
Fax: (800) 866-1611

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 45D2219381 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/22/2021 and was last updated on 8/23/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QX0100XClinic/CenterOccupational MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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