Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Revolution Health & Wellness Clinic PLLC

Organization Family Medicine Physician · NPI 1649515446

Revolution Health & Wellness Clinic PLLC provides Family Medicine Physician services in Glenpool, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2012.

Licensed in
OK
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

12142 S Yukon Ave
Glenpool, OK 74033-6621
Phone: (918) 935-3636
Fax: (918) 935-3635
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4353 (OK)

Record details

NPI number1649515446
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chad Edwards — Physician/Owner · (918) 935-3636
NPI enumeratedDecember 5, 2012
Last updated in NPPESFebruary 22, 2021
Certification dateFebruary 22, 2021
Mailing address2865 E Skelly Dr Ste 300, Tulsa, OK 74105-6233

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