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General NPI Number Information
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NPI Number | 1699635946
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Entity Type | Organization
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Legal Business Name | DEBRY VITALITY ACADEMIES PC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 6140 BRENT THURMAN WAY STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89148-5016
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Country | US
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Telephone | 702-602-5002
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Fax | 702-988-8818
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Provider Business Mailing Address
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Address Line | 6140 BRENT THURMAN WAY STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89148-5016
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Country | US
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Telephone | 702-602-5002
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Fax | 702-988-8818
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | PETER WINSTON DEBRY
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Credential | MD
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Telephone | 702-602-5002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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