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

Revolution Health & Wellness Clinic PLLC

Organization Family Medicine Physician · NPI 1649515446

Revolution Health & Wellness Clinic PLLC is a Family Medicine Physician in Glenpool, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2012.

Licensed in
OK
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

12142 S Yukon Ave
Glenpool, OK 74033-6621
Phone: (918) 935-3636
Fax: (918) 935-3635
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4353 (OK)

Record details

NPI number1649515446
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chad Edwards — Physician/Owner · (918) 935-3636
NPI enumeratedDecember 5, 2012
Last updated in NPPESFebruary 22, 2021
Certification dateFebruary 22, 2021
Mailing address2865 E Skelly Dr Ste 300, Tulsa, OK 74105-6233

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