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Organization
REVIVO MEDICAL PA
Active
Organization
REVIVO MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL K SCHRADER MD (OWNER)
(469) 235-1263
Entity
Organization
Contact information
Practice address
9441 LYNDON B JOHNSON FWY STE 103B, DALLAS, TX 75243-4545
(469) 466-2251
Mailing address
9441 LYNDON B JOHNSON FWY STE 103B, DALLAS, TX 75243-4545
(469) 466-2251
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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