| Reviveme Healthcare, Pllc | |
|
2637 Fairmont Dr, Grand Prairie TX 75052-4009 | |
| (817) 964-8349 | |
| Not Available |
| Full Name | Reviveme Healthcare, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2637 Fairmont Dr,, Grand Prairie, Texas |
| Authorized Official Name and Position | Amanda Tejera (MANAGING MEMBER) |
| Authorized Official Contact | 8179648349 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reviveme Healthcare, Pllc 1301 E. Debbie Lane Suite 102, #1525 Mansfield TX 76063-3376 Ph: () - | Reviveme Healthcare, Pllc 2637 Fairmont Dr, Grand Prairie TX 75052-4009 Ph: (817) 964-8349 |
| NPI Number | 1801659453 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 02/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801659453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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