REVIVAL MEDICAL GROUP PLLC
NPI 1093650806
Family Medicine - Obesity Medicine in Kyle, TX
NPI Status: Active since April 20, 2026
Contact Information
1300 DACY LN BLDG 2
STE. 270
KYLE, TX
ZIP 78640
Phone: (310) 745-9935
- Organization
- Family Medicine
- Obesity Medicine
- CLIA Number: 45D2343123
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 04-30-2028
About REVIVAL MEDICAL GROUP PLLC
This page provides the complete NPI Profile along with additional information for Revival Medical Group Pllc, a primary care provider established in Kyle, Texas operating as a Family Medicine, focusing in obesity medicine . The healthcare provider is registered in the NPI registry with number 1093650806 assigned on April 2026. The practitioner's primary taxonomy code is 207QB0002X. The provider is registered as an organization and their NPI record was last updated April 2026. Revival Medical Group Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Alan Lee Lane Md (Owner)
- NPI
- 1093650806
- Provider Name
- REVIVAL MEDICAL GROUP PLLC
- Entity Type
- Organization
- Location Address
- 1300 DACY LN BLDG 2 STE. 270 KYLE, TX 78640
- Location Phone
- (310) 745-9935
- Mailing Address
- 119 CREST VIEW DR LAKEWAY, TX 78734
- Mailing Phone
- (310) 745-9935
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-20-2026
- Last Update Date
- 04-20-2026
- Code Navigator
A primary care provider (PCP) like Revival Medical Group Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Obesity Medicine
- Taxonomy Code
- 207QB0002X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 2 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2343123
- Facility Type
- Practitioner Other
- Certificate Effective Date
- May 01, 2026
- Certificate Expiration Date
- April 30, 2028
- Laboratory Director
- DR. ALAN L. LEE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Revival Medical Group Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1093650806, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093650806, enumerated as an "organization" on April 20, 2026.
The provider is located at 1300 DACY LN BLDG 2 STE. 270 KYLE, TX 78640 and the phone number is (310) 745-9935.
Family Medicine with taxonomy code 207QB0002X and a focus in Obesity Medicine.
