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NPI Code Detail

MEDICARE: PREMISE HEALTH OF TEXAS MEDICAL, P.A

MEDICARE: PREMISE HEALTH OF TEXAS MEDICAL, P.A
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1013871227
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMISE HEALTH OF TEXAS MEDICAL, P.A
Provider Business Mailing Address
First Line : 5500 MARYLAND WAY STE 120
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4993
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1010 N SAINT MARYS ST RM 14AA
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78215-2109
Country : US
Telephone Number : 210-436-1722
Fax Number : 210-634-2403
Authorized Official
Title or Position : PRESIDENT
Name : JONATHAN B LEIZMAN
Credential :
Telephone Number : 216-479-9063
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “PREMISE HEALTH OF TEXAS MEDICAL, P.A ” Practice Location

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