Revive Hormone Clinic PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

REVIVE HORMONE CLINIC PLLC

Practice address

13316 S Western Ave
Suite F
Oklahoma City, OK 73170-7302

Phone

(405) 703-8882

Fax

(405) 237-3799

NPI assigned

Mar 13, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ernest Byron Foster II, MD

Title

Manager

Phone

(405) 703-8882

Specialties & licenses 1

Addresses

Other names 1

• Revive Therapy Other name

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1912448754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13316 S WESTERN AVE",
            "address_2": "SUITE F",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707302",
            "telephone_number": "405-703-8882",
            "fax_number": "405-237-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13316 S WESTERN AVE",
            "address_2": "SUITE F",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707302",
            "telephone_number": "405-703-8882",
            "fax_number": "405-237-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HORMONE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "BYRON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-703-8882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Revitalizing Hope, LLC
• Revive Clinic LLC
• Revive DME
• Revive Health of Oklahoma LLC
• Revive Health Services
• Revive Infusion
• Revive Medical LLC
• Revive Medical Urgent Care LLC
• Revive Performance, Inc.
• Revive Therapy Plus Wellness

• Health Service Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Health Service Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.