| Revive Men's Clinic | |
|
2129 Martin Dr Suite 200 Bedford TX 76021-5995 | |
| (817) 391-0130 | |
| (817) 391-0136 |
| Full Name | Revive Men's Clinic |
|---|---|
| Speciality | General Practice |
| Location | 2129 Martin Dr, Bedford, Texas |
| Authorized Official Name and Position | Marie Serna (OFFICE DIRECTOR) |
| Authorized Official Contact | 8173910130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Men's Clinic 2129 Martin Dr Suite 200 Bedford TX 76021-5995 Ph: (817) 391-0130 | Revive Men's Clinic 2129 Martin Dr Suite 200 Bedford TX 76021-5995 Ph: (817) 391-0130 |
| NPI Number | 1295144186 |
|---|---|
| Provider Enumeration Date | 08/05/2014 |
| Last Update Date | 08/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295144186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | D5910 (Texas) | Primary |
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