PREMISE HEALTH OF TEXAS MEDICAL P.A NPI 1871201962

NPI Information

NPI: 1871201962
Provider Name: PREMISE HEALTH OF TEXAS MEDICAL, P.A
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 45D1052461

Address:
100 CITI HEALTH SERVICES DRIVE
FLOOR M
SAN ANTONIO, TX
ZIP 78245
Phone: (210) 357-8230
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PREMISE HEALTH OF TEXAS MEDICAL, P.A is a multi-specialty clinic center in San Antonio, TX. PREMISE HEALTH OF TEXAS MEDICAL, P.A NPI is 1871201962. The provider is registered as an organization entity type.

The provider's business location address is:

100 CITI HEALTH SERVICES DRIVE
FLOOR M
SAN ANTONIO, TX
ZIP 78245
Phone: (210) 357-8230

The provider's authorized official is Jonathan 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 45D1052461 - industrial with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2022 and was last updated on 11/8/2022.

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
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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

NPI Synchronization or Removal

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