Revolution Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVOLUTION WELLNESS

Doing business as

Performance Chiropractic and Sports Rehab, PLLC

Practice address

6011 Broadway St
101
San Antonio, TX 78209-4554

Phone

(210) 771-2136

Fax

(210) 247-9463

NPI assigned

May 3, 2012

Last updated

Feb 4, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lauren Brooke Duarte, DC

Title

Doctor

Phone

(210) 771-2136

Specialties & licenses 1

Addresses

Other names 1

• Performance Chiropractic and Sports Rehab, PLLC Doing business as

Locations

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1407115934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 BROADWAY ST",
            "address_2": "101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094554",
            "telephone_number": "210-771-2136",
            "fax_number": "210-247-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 BROADWAY ST",
            "address_2": "101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094554",
            "telephone_number": "210-771-2136",
            "fax_number": "210-247-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-03",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "210-771-2136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Chiropractic and Sports Rehab, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Revitalizing Minds Therapy Solutions
• Revival Performance Physical Therapy
• Revived Beauty LLC (Her Power Rx Health Solutions)
• Revolution Mental Health Counseling, PLLC
• Revolution Physical Therapy & Wellness
• Gangadhar Revuluri, PHARMACIST
• Paul Jonathan Rex, IDMT
• Jessica Nicole Rexrode
• Leilani Rey, CCC-SLP
• Brent Steven Reyburn, D.O.

• Chiropractor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.