Re.Vitalize Wellness, LLC
Preventive Medicine, Public Health & General Preventive Medicine in Irving, TX. Organization (NPI-2).
NPI number1457276743
StatusActive
Last updated in NPPESAug 13, 2026
Details
- NPI
- 1457276743
- Entity type
- Organization (NPI-2)
- Legal business name
- Re.Vitalize Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Aug 13, 2026
- Certification date
- Aug 13, 2026
- Last updated
- Aug 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | – | – | Yes |
Practice location
1110 Cottonwood Ln Ste 165Irving, TX 75038-6117
Phone 817-677-8033
Mailing address
1110 Cottonwood Ln Ste 165Irving, TX 75038-6117
Phone 817-677-8033
Authorized official
Kristi Harral
Co-Owner
8176778033
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