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General NPI Number Information
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NPI Number | 1154131571
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Entity Type | Organization
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Legal Business Name | PEAK NUTRITION AND PERFORMANCE
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 6907 MILL FALLS DR
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City | DALLAS
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State | TX
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Zip | 75248-2913
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Country | US
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Telephone | 214-236-7909
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Fax |
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Provider Business Mailing Address
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Address Line | 6907 MILL FALLS DR
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City | DALLAS
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State | TX
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Zip | 75248-2913
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Country | US
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Telephone | 214-236-7909
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAXTON BOYER
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Credential | MS, RDN, CSSD, LD
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Telephone | 214-236-7909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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