Organization · NPI-2

Aeon Psychological Services PLLC

Psychologist · San Antonio, TX

NPI number1548873227
StatusActive
Last updated in NPPESDec 7, 2022

Details

NPI
1548873227
Entity type
Organization (NPI-2)
Legal business name
Aeon Psychological Services PLLC
Organization subpart
No
Enumeration date
Aug 24, 2020
Certification date
Dec 7, 2022
Last updated
Dec 7, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103T00000X Psychologist––Yes

Practice location

921 Proton Rd
San Antonio, TX 78258-4203

Phone 210-551-1408

Mailing address

921 Proton Rd
San Antonio, TX 78258-4203

Phone 210-551-1408

Other practice locations

510 Med Ct Ste 106
San Antonio, TX 78258-3483

Phone 210-495-0675

Authorized official

Wade Petree
Owner
2105511408

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Psychologist providers in San Antonio, TX