OrganizationActive
Premise Health of Texas Medical, P.A
NPI 1417455346 · Multi-Specialty Clinic/Center · Irving, TX
Provider details
- NPI number
- 1417455346
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jon Leizman, President(216) 479-9063
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6400 Las Colinas Blvd
Irving, TX 75039-2900
Phone: (972) 655-5000
Fax: (972) 655-5517
Street-level locationGet directions
Mailing address
5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Other names (DBA / former)
- Doing business as
- Live Well at Citi Medical Clinic
Registry dates
- Enumerated
- 2018-01-25
- Last updated
- 2022-08-23
- Certified
- 2022-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.