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Organization
PREMIUM CHOICE PHYSICIANS
Active
Organization
PREMIUM CHOICE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DEJESUS (PRESIDENT)
(817) 751-1811
Entity
Organization
Contact information
Practice address
5 GROGANS PARK DR STE 203, THE WOODLANDS, TX 77380-2191
(940) 488-4290
(940) 536-0539
Mailing address
5 GROGANS PARK DR STE 203, THE WOODLANDS, TX 77380-2191
(940) 488-4290
(940) 536-0539
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
NULL
163WH0200X
Home Health Registered Nurse
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
2251G0304X
Geriatric Physical Therapist
—
NULL
2251G0304X
Geriatric Physical Therapist
—
—
2278G1100X
General Care Certified Respiratory Therapist
—
NULL
2278G1100X
General Care Certified Respiratory Therapist
—
—
2278H0200X
Home Health Certified Respiratory Therapist
—
NULL
2278H0200X
Home Health Certified Respiratory Therapist
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/29/2019
Last updated
01/24/2023
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