Provider Demographics
NPI:1346584091
Name:PSI PREMIER SPECIALTIES, INC.
Entity type:Organization
Organization Name:PSI PREMIER SPECIALTIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-371-1700
Mailing Address - Street 1:8800 SHOAL CREEK BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-6818
Mailing Address - Country:US
Mailing Address - Phone:512-371-1700
Mailing Address - Fax:512-371-1700
Practice Address - Street 1:15685B SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3732
Practice Address - Country:US
Practice Address - Phone:210-545-7070
Practice Address - Fax:210-545-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies