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General NPI Number Information
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NPI Number | 1033485669
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Entity Type | Organization
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Legal Business Name | MORRELL DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3560 DELAWARE ST SUITE 901
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City | BEAUMONT
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State | TX
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Zip | 77706-3000
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Country | US
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Telephone | 409-898-3900
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Fax | 409-898-3901
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Provider Business Mailing Address
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Address Line | 3560 DELAWARE ST SUITE 901
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City | BEAUMONT
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State | TX
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Zip | 77706-3000
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Country | US
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Telephone | 409-898-3900
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Fax | 409-898-3901
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. PETER MORRELL
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Credential | D.O.
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Telephone | 409-898-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | M8197
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | M8197
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License Number State | TX
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