NPIMap

Organization Active NPI

Premise Health of Texas Medical, P.a

  • Multi-Specialty Clinic/Center
  • Dickinson, TX
National Provider Identifier
1104599026
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF TEXAS MEDICAL, P.A
Practice address
1455 FM 646 Rd W Ste 100
Dickinson, TX 77539-2038
Phone
(281) 316-8757
NPI assigned
Jul 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jon Leizman
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1455 FM 646 Rd W Ste 100
Dickinson, TX 77539-2038

Mailing address

5500 Maryland Way
Brentwood, TN 37027-7048

Other names 1

  • Galveston Co - Dickinson Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Texas Medical PA78 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1104599026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 FM 646 RD W STE 100",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775392038",
            "telephone_number": "281-316-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF TEXAS MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galveston Co - Dickinson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Galveston Co - Dickinson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickinson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.