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General NPI Number Information
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NPI Number | 1649199829
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Entity Type | Organization
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Legal Business Name | REVIVE PCMS AUSTIN LLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 1295 S HIGHWAY 183 STE 101
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City | LEANDER
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State | TX
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Zip | 78641-4557
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Country | US
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Telephone | 972-236-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 1295 S HIGHWAY 183 STE 101
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City | LEANDER
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State | TX
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Zip | 78641-4557
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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 | CEO
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Name | ALI ALHELEJI
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Credential |
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Telephone | 469-363-3157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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