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General NPI Number Information
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NPI Number | 1750898698
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Entity Type | Individual
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Provider Name | PEYTON JONES
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Gender | Male
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Dates
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Enumeration Date | 12/31/2017
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 3432 GREYSTONE DR STE 120
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City | AUSTIN
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State | TX
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Zip | 78731-2371
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Country | US
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Telephone | 512-881-6739
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 S PLEASANT VALLEY RD APT 1124
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City | AUSTIN
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State | TX
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Zip | 78741-4610
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Country | US
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Telephone | 419-953-1358
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 39142
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License Number State | TX
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