NPIMap

Organization Active NPI

Premise Health of Texas Medical, P.a

Doing business as Triumph Vought Medical Center - Marshall

  • Health Service Clinic/Center
  • Grand Prairie, TX
National Provider Identifier
1386069821
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
PREMISE HEALTH OF TEXAS MEDICAL, P.A
Doing business as
Triumph Vought Medical Center - Marshall
Practice address
1601 W Marshall Dr
Grand Prairie, TX 75051-2801
Phone
(972) 595-9900
Fax
(972) 595-9998
NPI assigned
Feb 20, 2014
Last updated
Aug 23, 2022By the provider in NPPES
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, M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

1601 W Marshall Dr
Grand Prairie, TX 75051-2801

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (972) 595-9900

Other names 1

  • Triumph Vought Medical Center - Marshall 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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1386069821",
    "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": "370274948",
            "telephone_number": "972-595-9900",
            "fax_number": "972-595-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W MARSHALL DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750512801",
            "telephone_number": "972-595-9900",
            "fax_number": "972-595-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF TEXAS MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "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",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triumph Vought Medical Center - Marshall",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Triumph Vought Medical Center - Marshall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, 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.