MEDICARE: REVNIXDME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1548192495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REVNIXDME LLC

Provider Business Mailing Address
First Line	:	1667 W CAMPBELL RD APT 5302
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2355
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1667 W CAMPBELL RD APT 5302
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2355
Country	:	US
Telephone Number	:	850-558-2918
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DELAINE LANEY
Credential	:
Telephone Number	:	850-558-2918

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/03/2026

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Directions to “REVNIXDME LLC ” Practice Location

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