Meredith N Revell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08375 Issued in TX

Practice address

431 E State Highway 114 Ste 300
Southlake, TX 76092-1484

Phone

(817) 251-6500

Fax

(817) 442-0050

NPI assigned

May 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• PDP of Texas, PLLC

  • Dermatology Physician
  • Dallas, TX
  • NPI 1629025739
  Medicare reassignment
• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146
  Medicare reassignment
• Angela G Bowers, MD PA

  • Specialist
  • Southlake, TX
  • NPI 1942233895
  NPD (past)
• Pediatric Dermatology of No. TX

  • Pediatric Dermatology Physician
  • Grapevine, TX
  • NPI 1487060679
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1255777900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 N CENTRAL EXPY STE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310928",
            "telephone_number": "214-987-3376",
            "fax_number": "469-532-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E STATE HIGHWAY 114 STE 300",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921484",
            "telephone_number": "817-251-6500",
            "fax_number": "817-442-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELL",
        "first_name": "MEREDITH",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanna Renteria
• Resolve Counseling Group
• Restoring Hope Counseling & Consulting , PLLC
• Return2Sports Physical Therapy
• Reveles Clinical Services
• Andrew Reyna, M.D.
• Marietta Baccus Richard, PH.D
• Karisha Delvon Richards, MA, LPC
• Patricia Richardson
• Zachary L Richmond, MMFT, LPC

• Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.