OrganizationActive
Revival Dermatology PLLC
NPI 1679149702 · Dermatology Physician · Dallas, TX
Provider details
- NPI number
- 1679149702
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lisa Pruett, President(504) 319-1407
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8201 Preston Rd Ste 440
Dallas, TX 75225-6209
Phone: (214) 675-3227
Fax: (972) 435-4481
Street-level locationGet directions
Mailing address
8201 Preston Rd Ste 440
Dallas, TX 75225-6209
Registry dates
- Enumerated
- 2021-05-30
- Last updated
- 2021-06-11
- Certified
- 2021-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.