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

Revivo Medical PA

Organization Internal Medicine Physician · NPI 1528955358

Revivo Medical PA is an Internal Medicine Physician in Dallas, Texas. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9441 Lyndon B Johnson Fwy Ste 103B
Dallas, TX 75243-4545
Phone: (469) 466-2251
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1528955358
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Schrader — Owner · (469) 235-1263
NPI enumeratedJune 23, 2025
Last updated in NPPESJune 23, 2025
Certification dateJune 23, 2025
Mailing address9441 Lyndon B Johnson Fwy Ste 103b, Dallas, TX 75243-4545

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