# PREMISE HEALTH OF TEXAS MEDICAL, P.A

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fuji Diosynth Biotechnologies Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831771518
- **Authorized official:** DR. JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 8872 HSC PKWY RM 106, BRYAN, TX 77807-1107
- **Practice address phone:** (979) 431-3682
- **Practice address fax:** (800) 866-1611
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/22/2021
- **Last updated:** 08/23/2022