Provider Demographics
NPI:1609260157
Name:GABRIEL M PEAL M.D,.,PA
Entity Type:Organization
Organization Name:GABRIEL M PEAL M.D,.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-558-4900
Mailing Address - Street 1:500 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 221
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5302
Mailing Address - Country:US
Mailing Address - Phone:501-558-4900
Mailing Address - Fax:501-558-4909
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 221
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-558-4900
Practice Address - Fax:501-558-4909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1660174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty