Individual
MR. REVI D PEXA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1776 N SCOTTSDALE RD UNIT 368, SCOTTSDALE, AZ 85252-3616
(480) 201-5264
(480) 393-1970
Mailing address
1776 N SCOTTSDALE RD #368, SCOTTSDALE, AZ 85252
(480) 201-5264
(480) 393-1970
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2473
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470295
—
AZ
Enumeration date
07/12/2006
Last updated
03/08/2017
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