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General NPI Number Information
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NPI Number | 1083572416
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Entity Type | Organization
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Legal Business Name | REV1VED WELLNESS PLLC
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 3422 BUSINESS CENTER DR STE 1061054
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City | PEARLAND
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State | TX
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Zip | 77584-4155
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Country | US
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Telephone | 713-614-3247
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 NATIVE REEF WAY
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City | IOWA COLONY
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State | TX
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Zip | 77583-8805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ASIA SWINNEY
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Credential |
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Telephone | 662-299-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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