NPIMap

Organization Active NPI

Premise Health of Texas Medical, P.a

Doing business as Fuji Diosynth Biotechnologies Health Center

  • Occupational Medicine Clinic/Center
  • Bryan, TX
National Provider Identifier
1831771518
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
PREMISE HEALTH OF TEXAS MEDICAL, P.A
Doing business as
Fuji Diosynth Biotechnologies Health Center
Practice address
8872 HSC Pkwy RM 106
Bryan, TX 77807-1107
Phone
(979) 431-3682
Fax
(800) 866-1611
NPI assigned
Apr 22, 2021
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
Dr. Jon Leizman, MD
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X NU Primary

Addresses

Primary practice location

8872 HSC Pkwy RM 106
Bryan, TX 77807-1107

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • Fuji Diosynth Biotechnologies Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2219381Premise Health of Texas PA8872 HSC Parkway, RM 106, Bryan, TX 77807Certificate of waiverApr 4, 2027

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 19

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

View all 19

Locations

8872 Hsc Pkwy
Rm 106
Bryan, TX 77807
Phone (979) 431-3682

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1831771518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8872 HSC PKWY RM 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778071107",
            "telephone_number": "979-431-3682",
            "fax_number": "800-866-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF TEXAS MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "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_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuji Diosynth Biotechnologies Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fuji Diosynth Biotechnologies Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bryan, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.