Provider Demographics
NPI:1306421003
Name:PREUIT, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:PREUIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2977 AUSTIN BREEZE LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4884
Mailing Address - Country:US
Mailing Address - Phone:832-715-5645
Mailing Address - Fax:
Practice Address - Street 1:2977 AUSTIN BREEZE LN
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4884
Practice Address - Country:US
Practice Address - Phone:832-715-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider