# PREMIUM CHOICE PHYSICIANS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548824121
- **Authorized official:** DAVID DEJESUS (PRESIDENT)
- **Authorized official phone:** (817) 751-1811

## Contact information

- **Practice address:** 5 GROGANS PARK DR STE 203, THE WOODLANDS, TX 77380-2191
- **Practice address phone:** (940) 488-4290
- **Practice address fax:** (940) 536-0539
- **Mailing address:** 5 GROGANS PARK DR STE 203, THE WOODLANDS, TX 77380-2191
- **Mailing address phone:** (940) 488-4290
- **Mailing address fax:** (940) 536-0539

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 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