Organization
REVIVAL MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN LEE LANE MD (OWNER)
(512) 757-3259
Entity
Organization
Contact information
Practice address
1300 DACY LN BLDG 2, STE. 270, KYLE, TX 78640-4192
(310) 745-9935
Mailing address
119 CREST VIEW DR, LAKEWAY, TX 78734-5207
(310) 745-9935
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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