Individual
PETER DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
425 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1047
(512) 509-0200
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
39921
TX
103T00000X
Psychologist
39921
TX
Other
Enumeration date
06/08/2023
Last updated
12/28/2023
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