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General NPI Number Information
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NPI Number | 1235813114
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH REVISION PLLC
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 231 S COLLINS RD
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City | SUNNYVALE
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State | TX
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Zip | 75182-4624
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Country | US
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Telephone | 972-892-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 661 E MAIN ST STE 200 BOX 118
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-3365
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Country | US
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Telephone | 972-903-4343
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Fax | 800-782-4295
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Authorized Official
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Title or Position | OWNER / NURSE PRACTITIONER
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Name | KIMBERLY R NEELY
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Credential | NP
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Telephone | 972-978-2317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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