MEDICARE: PSI PREMIER SPECIALTIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1000697	TX
2	335E00000X	Prosthetic/Orthotic Supplier	101384	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	101372	OTHER	TX	TEXAS BOARD OF ORTHOTICS AND PROSTHETICS LICENSE

General Provider Information

NPI Number	:	1831470475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSI PREMIER SPECIALTIES, INC.

Provider Business Mailing Address
First Line	:	8900 SHOAL CREEK BLVD STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-6853
Country	:	US
Telephone Number	:	512-371-1700
Fax Number	:	512-371-1754

Provider Business Practice Location Address
First Line	:	11886 GREENVILLE AVE
Second Line	:	STE 114
City	:	DALLAS
State	:	TX
Zip	:	75243-0584
Country	:	US
Telephone Number	:	214-575-0441
Fax Number	:	214-570-9199

Authorized Official
Title or Position	:	CEO
Name	:	CHRIS LEONARD
Credential	:
Telephone Number	:	512-371-1700

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	02/12/2026

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Directions to “PSI PREMIER SPECIALTIES, INC. ” Practice Location

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