Provider Type Icon

PREMISE HEALTH OF TEXAS MEDICAL P.A NPI 1295326171


NPI Information

NPI: 1295326171
Provider Name: PREMISE HEALTH OF TEXAS MEDICAL, P.A

Doing Business As: CITY OF AUSTIN HEALTH & WELLNESS MOBILE CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 45D2215042

Address:
5202 E BEN WHITE BLVD STE 500
AUSTIN, TX
ZIP 78741
Phone: (512) 401-8447
Get Directions

PREMISE HEALTH OF TEXAS MEDICAL, P.A is a clinic center in Austin, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PREMISE HEALTH OF TEXAS MEDICAL, P.A NPI is 1295326171. The provider is registered as an organization entity type.
The provider Is Doing Business As City Of Austin Health & Wellness Mobile Clinic.

The provider's business location address is:

5202 E BEN WHITE BLVD STE 500
AUSTIN, TX
ZIP 78741-316
Phone: (512) 401-8447
Fax: (512) 727-4426

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 45D2215042 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2021 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.