Individual
DR. BRYAN MITCHELL REVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2840 COLLINGWOOD DRIVE, ROUND ROCK, TX 78665-5655
(512) 248-0912
(512) 248-0941
Mailing address
PO BOX 1645, ROUND ROCK, TX 78680-1645
(512) 248-0912
(512) 248-0941
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1695
TX
Other
Enumeration date
05/17/2007
Last updated
10/18/2010
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