Organization
ELEVATED MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHAN PETERSON PA-C (PA-C)
(210) 315-4601
Entity
Organization
Contact information
Practice address
204 E FAIR OAKS PL, ALAMO HEIGHTS, TX 78209-3811
(210) 315-4601
Mailing address
204 E FAIR OAKS PL, ALAMO HEIGHTS, TX 78209-3811
(210) 315-4601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/06/2025
Last updated
02/27/2025
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