Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Revival Dermatology PLLC

Organization Dermatology Physician · NPI 1679149702

Revival Dermatology PLLC is a Dermatology Physician in Dallas, Texas. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8201 Preston Rd Ste 440
Dallas, TX 75225-6209
Phone: (214) 675-3227
Fax: (972) 435-4481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1679149702
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Pruett — President · (504) 319-1407
NPI enumeratedMay 30, 2021
Last updated in NPPESJune 11, 2021
Certification dateJune 11, 2021
Mailing address8201 Preston Rd Ste 440, Dallas, TX 75225-6209

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