Provider Demographics
NPI:1639936990
Name:PEAK VASCULAR ACCESS, LLC
Entity Type:Organization
Organization Name:PEAK VASCULAR ACCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-680-6619
Mailing Address - Street 1:12101 PALISADES PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1244
Mailing Address - Country:US
Mailing Address - Phone:512-680-6619
Mailing Address - Fax:
Practice Address - Street 1:12101 PALISADES PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1244
Practice Address - Country:US
Practice Address - Phone:512-680-6619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care