NPIMap

Organization Active NPI

Peak Aesthetics and Wellness PLLC

  • Clinic/Center
  • San Angelo, TX
National Provider Identifier
1992586549
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PEAK AESTHETICS AND WELLNESS PLLC
Practice address
30 W Beauregard Ave Ste 100
San Angelo, TX 76903-5851
Phone
(210) 394-4521
NPI assigned
Oct 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Elisa Brantly, MDNPI 1619157427
Title
Owner
Phone
(210) 394-4521

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

30 W Beauregard Ave Ste 100
San Angelo, TX 76903-5851

Mailing address

30 W Beauregard Ave Ste 100
San Angelo, TX 76903-5851

National Provider Directory

National Provider Directory

Locations

30 W Beauregard Ave
Ste 100
San Angelo, TX 76903
Phone (210) 394-4521

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1992586549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W BEAUREGARD AVE STE 100",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W BEAUREGARD AVE STE 100",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035851",
            "telephone_number": "210-394-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK AESTHETICS AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "BRANTLY",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-394-4521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.