Individual
JOHN D REVEILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST, 600, HOUSTON, TX 77030-3000
(832) 325-7191
(713) 512-2246
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H3153
TX
207RR0500X
Rheumatology Physician
Primary
H3153
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89Y452
BCBS
TX
Enumeration date
07/17/2006
Last updated
02/11/2008
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