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Organization
REVIVE HEALTHCARE CLINIC LLC
Active
Organization
REVIVE HEALTHCARE CLINIC LLC
Active
Other names
Revive Healthcare Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHEKWUBE MARTHA OKOLI (OWNER)
(469) 567-9974
Entity
Organization
Contact information
Practice address
1221 WEST AIRPORT FWY STE# 209 UNIT B, IRVING, TX 75062
(214) 777-2703
(817) 865-1530
Mailing address
1221 WEST AIRPORT FWY STE# 209 UNIT B, IRVING, TX 75062
(214) 777-2703
(817) 865-1530
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/25/2024
Last updated
03/18/2025
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