Provider Demographics
NPI:1891434957
Name:PEAY, ANTHONY G
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:G
Last Name:PEAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7518 BEDFORD CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5458
Mailing Address - Country:US
Mailing Address - Phone:210-620-6340
Mailing Address - Fax:
Practice Address - Street 1:6041 WT MONTGOMERY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78252-2234
Practice Address - Country:US
Practice Address - Phone:210-646-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health