NPIMap

Organization Active NPI

Revive Med Partners, LLC

Doing business as Revive Primary Care & Med Spa

  • Internal Medicine Physician
  • Highland Village, TX
National Provider Identifier
1669237798
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
REVIVE MED PARTNERS, LLC
Doing business as
Revive Primary Care & Med Spa
Practice address
2570 FM 407 Ste 160
Highland Village, TX 75077-3055
Phone
(214) 930-1659
NPI assigned
Feb 19, 2024
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Aiman Shokr, MDNPI 1164748810
Title
MD
Phone
(972) 236-7060

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Chiropractor 111N00000X NU
Emergency Medicine Physician 207P00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2570 FM 407 Ste 160
Highland Village, TX 75077-3055

Mailing address

916 Saint Mark Dr
Murphy, TX 75094-5120

Other practice location 1

2005 NE Green Oaks Blvd Ste 150
Arlington, TX 76006-3289
Phone (817) 778-9157

Other practice location 2

3330 Douglas Ave
Dallas, TX 75219-2717
Phone (469) 638-9638

Other names 1

  • REVIVE PRIMARY CARE & MED SPA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240601000564 TX Part B Supplier - Clinic/Group Practice 7618419920 Receives reassigned benefits from 21 practitioners
Practice locations: Colleyville, TX; Dallas, TX; Frisco, TX; Highland Village, TX; McKinney, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2300100Revive Primary Care & Med Spa2570 FM 407 Ste. 160, Highland Village, TX 75077Certificate of waiverMar 3, 2028

National Provider Directory

National Provider Directory

Locations

1124 Glade Rd
Ste 160
Colleyville, TX 76034
Phone (817) 984-3460

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1669237798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 SAINT MARK DR",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750945120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 FM 407 STE 160",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750773055",
            "telephone_number": "214-930-1659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 NE Green Oaks Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760063289",
            "country_code": "US",
            "telephone_number": "817-778-9157",
            "fax_number": "866-493-3020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3330 Douglas Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752192717",
            "country_code": "US",
            "telephone_number": "469-638-9638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE MED PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "SHOKR",
        "authorized_official_first_name": "AIMAN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "972-236-7060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REVIVE PRIMARY CARE & MED SPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highland Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.