Organization Active NPI

Revaya Wellness, PLLC

  • Adult Medicine Physician
  • San Marcos, TX
National Provider Identifier
1083573307
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
REVAYA WELLNESS, PLLC
Practice address
2001 Medical Pkwy Ste C
San Marcos, TX 78666-7581
Phone
(512) 360-8144
NPI assigned
Jan 21, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cara Grant, NPNPI 1992576391
Title
Co/Owner
Phone
(512) 360-8144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

2001 Medical Pkwy Ste C
San Marcos, TX 78666-7581

Mailing address

2001 Medical Pkwy Ste C
San Marcos, TX 78666-7581
Phone (512) 360-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260429001745 TX Part B Supplier - Clinic/Group Practice 4486121225 Receives reassigned benefits from 2 practitioners
Practice locations: San Marcos, TX

National Provider Directory

National Provider Directory

Locations

2001 Medical Pkwy
Ste C
San Marcos, TX 78666
Phone (512) 360-8144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1083573307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY STE C",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667581",
            "telephone_number": "512-360-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY STE C",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667581",
            "telephone_number": "512-360-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVAYA WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "CARA",
        "authorized_official_title_or_position": "CO/OWNER",
        "authorized_official_telephone_number": "512-360-8144",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.