Organization
PREMISE HEALTH OF TEXAS MEDICAL, P.A
Active
Other names
The Wellness Center powered by Premise Health
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
1 LOCKHEED BLVD, FORT WORTH, TX 76108-3619
(972) 603-3000
(972) 603-2922
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
08/23/2022
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