Olvia Revelo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P1486 Issued in TX

Practice address

18220 State Highway 249
Suite 400
Houston, TX 77070-4347

Phone

(281) 737-0570

Fax

(281) 807-6024

NPI assigned

Jun 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: orevelo14317@direct.houstonmethodist.org

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.

• TMH Physician Associates PLLC

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1275779225

  Family Medicine

  Medicare reassignment NPD
• TMH Physician Associates PLLC

  • Orthopaedic Surgery Physician
  • Spring, TX
  • NPI 1043061351
  NPD
• C3Erow, LLC

  • Emergency Care Clinic/Center
  • Rockport, TX
  • NPI 1548700990
  NPD (past)
• Fastpass Ucc, PLLC

  • Urgent Care Clinic/Center
  • Carrollton, TX
  • NPI 1811355639
  NPD (past)
• Fastpass Ucdfw, PLLC

  • Community/Retail Pharmacy
  • DFW Airport, TX
  • NPI 1497271589
  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1356579304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18220 STATE HIGHWAY 249",
            "address_2": "SUITE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704347",
            "telephone_number": "281-737-0570",
            "fax_number": "281-807-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18220 STATE HIGHWAY 249",
            "address_2": "SUITE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704347",
            "telephone_number": "281-737-0570",
            "fax_number": "281-807-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELO",
        "first_name": "OLVIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "34152",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "311025",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-11861",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019000473",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "277453",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01467090",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8FT326",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8EL997",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295420801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295420803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amee Revana, DO
• Shruti Revankar, MD
• Reveille Dental
• John D Reveille, M.D.
• Isabel Revelo
• Marites Reventar
• America Stephanie Revere, MD
• Reverence Equality Healthcare LLC
• Reverie Home Care Agency, LLC
• Maria Luisa Revert Font, M.D.

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.