Provider Demographics
NPI:1710327184
Name:PREVITY SURGICAL EAST, PLLC
Entity Type:Organization
Organization Name:PREVITY SURGICAL EAST, PLLC
Other - Org Name:PREVITY CLINIC FOR SURGICAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:K
Authorized Official - Last Name:PEEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-835-9500
Mailing Address - Street 1:740 HOSPITAL DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4664
Mailing Address - Country:US
Mailing Address - Phone:409-835-9500
Mailing Address - Fax:409-835-9501
Practice Address - Street 1:5030 CRENSHAW RD
Practice Address - Street 2:SUITE 140
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3140
Practice Address - Country:US
Practice Address - Phone:409-835-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty