Individual provider Active NPI

America Stephanie Revere, MD

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1821613431
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
W7118 Issued in TX
Practice address
110 Vintage Park Blvd Ste 280
Houston, TX 77070-4048
Phone
(281) 453-5100
NPI assigned
Jun 9, 2020
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X W7118 TX Primary

Addresses

Primary practice location

110 Vintage Park Blvd Ste 280
Houston, TX 77070-4048

Mailing address

110 Vintage Park Blvd Ste 280
Houston, TX 77070-4048
Phone (281) 453-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200724002615 GA Order and Referring Only - General SurgeryPractitioner - General Surgery 1951725761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11900GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David D. Davila, D.O., P.a. Surgery Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1821613431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VINTAGE PARK BLVD STE 280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704048",
            "telephone_number": "281-453-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 VINTAGE PARK BLVD STE 280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704048",
            "telephone_number": "281-453-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVERE",
        "first_name": "AMERICA",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "W7118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.