Healthcare Provider Details

I. General information

NPI: 1225813629
Provider Name (Legal Business Name): PEAK EMG PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12709 TOEPPERWEIN RD STE 101
LIVE OAK TX
78233-3259
US

IV. Provider business mailing address

326 TOPHILL RD
SAN ANTONIO TX
78209-3446
US

V. Phone/Fax

Practice location:
  • Phone: 210-625-7433
  • Fax:
Mailing address:
  • Phone: 210-854-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SONRIE G PICKENS
Title or Position: OWNER
Credential: PT, DPT
Phone: 210-854-0340