Camille Haworth Rever

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15005 Issued in TX

Practice address

17101 Preston Rd Ste 200
Dallas, TX 75248-1374

Phone

(972) 239-4441

Fax

(972) 239-1597

NPI assigned

Aug 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

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.

• Kelly L Wimberly MD PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1578589842
  Medicare reassignment

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1366052318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17101 PRESTON RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481374",
            "telephone_number": "972-239-4441",
            "fax_number": "972-239-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 PRESTON RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481374",
            "telephone_number": "972-239-4441",
            "fax_number": "972-239-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVER",
        "first_name": "CAMILLE",
        "middle_name": "HAWORTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15005",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Buenaflor Reveldez, FNP
• Guadalupe Reveles
• Melissa Reveles, OD
• Sonia Reveles, CRNA
• Johannah Ruth Revelle, CNIM, R. EPT.
• Robert Rever, PT, DPT
• Marta Revilla-Leon, DDS, MSD
• Leslie Revilla
• Revision Counseling Services
• Revival Dermatology PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.