Organization
REVELATION HOUSE CALLS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HANSEN NEMAT CEO (PRESIDENT)
(469) 688-9800
Entity
Organization
Contact information
Practice address
25 SHOREHAVEN LN, HICKORY CREEK, TX 75065-2938
(146) 968-8980
Mailing address
1628 W HEBRON PKWY STE 138, CARROLLTON, TX 75010-6311
(469) 688-9800
(972) 920-3399
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/01/2017
Last updated
03/15/2021
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