Provider Demographics
NPI:1659892453
Name:LEMONS, PETER (MS, PHD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:LEMONS
Suffix:
Gender:M
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 WESTERN TRAILS BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1601
Mailing Address - Country:US
Mailing Address - Phone:512-537-9933
Mailing Address - Fax:
Practice Address - Street 1:2222 WESTERN TRAILS BLVD STE 107
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1601
Practice Address - Country:US
Practice Address - Phone:512-537-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38038103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical