Provider Demographics
NPI:1134317969
Name:PEEL, GARRETT K (MD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:K
Last Name:PEEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6025 METROPOLITAN DR STE 208
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-2409
Mailing Address - Country:US
Mailing Address - Phone:409-835-9500
Mailing Address - Fax:409-835-9501
Practice Address - Street 1:6025 METROPOLITAN DR STE 208
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706
Practice Address - Country:US
Practice Address - Phone:409-835-9500
Practice Address - Fax:409-835-9501
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN50555208600000X
TXN3987208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP00649015OtherRAILROAD MEDICARE
MN893437000Medicaid
MN893437000Medicaid