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NPI Code Detail

MEDICARE: DR. REVIS ANN MASSEY PSYD

MEDICARE: DR. REVIS ANN MASSEY PSYD
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
1103TC0700XClinical Psychologist38179TX
2103T00000XPsychologist38179TX

General Provider Information

NPI Number : 1548746753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REVIS ANN MASSEY PSYD
Provider Business Mailing Address
First Line : 6221 CHAPEL HILL BLVD STE 300
Second Line :
City : PLANO
State : TX
Zip : 75093-4750
Country : US
Telephone Number : 786-543-2428
Fax Number :
Provider Business Practice Location Address
First Line : 2150 LAKESIDE BLVD STE 100
Second Line :
City : RICHARDSON
State : TX
Zip : 75082-4467
Country : US
Telephone Number : 786-543-2428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2018
Last Update Date : 02/10/2026

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Directions to “ DR. REVIS ANN MASSEY PSYD” Practice Location

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