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REVIVAL MEDICAL GROUP PLLC
NPI 1093650806
Family Medicine - Obesity Medicine in Kyle, TX

Active since April 20, 2026CLIA 45D2343123 · Waiver
1300 DACY LN BLDG 2, STE. 270, KYLE, TX 78640(310) 745-9935 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revival Medical Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVIVAL MEDICAL GROUP PLLC (NPI 1093650806) is a healthcare organization registered as an obesity medicine in Kyle, Texas and active in the NPI registry since April 2026. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Alan Lee Lane, Owner, as its authorized official.

NPPES Registry Identity

NPI1093650806
Entity TypeOrganization
Primary Taxonomy207QB0002X
Legal Business NameREVIVAL MEDICAL GROUP PLLC
Location Address1300 DACY LN BLDG 2, STE. 270Kyle, TX 78640-4192
Mailing Address119 Crest View DrLakeway, TX 78734-5207 · (310) 745-9935
Phone(310) 745-9935
Organization SubpartNo
Authorized OfficialAlan Lee LaneOwner · (512) 757-3259
Enumeration DateApril 20, 2026
NPPES CertifiedApril 20, 2026
✔ NPI 1093650806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Obesity MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QB0002X
Definition
A family medicine physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
1300 DACY LN BLDG 2, Kyle, TX 78640
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2343123

Revival Medical Group PLLC · Kyle, TX
Active · expires Apr 30, 2028
CLIA Number45D2343123
Laboratory TypePractitioner Other
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorDr. Alan L. Lee
Laboratory Phone(737) 378-2122
Laboratory LocationRevival Medical Group PLLC1300 Dacy Ln Bldg 2 Ste 270, Kyle, TX 78640
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revival Medical Group PLLC's NPI number?

The NPI number for Revival Medical Group PLLC is 1093650806. It was assigned to this organization in the NPPES registry on April 20, 2026.

Where is Revival Medical Group PLLC located?

Revival Medical Group PLLC is located at 1300 Dacy Ln Bldg 2 Ste. 270, Kyle, TX 78640. The listed phone number is (310) 745-9935.

What is Revival Medical Group PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Obesity Medicine, with taxonomy code 207QB0002X.

Does Revival Medical Group PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2343123) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Revival Medical Group PLLC was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.