Provider Demographics
NPI:1003114893
Name:MEDIREHAB AND PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MEDIREHAB AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-365-9100
Mailing Address - Street 1:8831 LONG POINT RD
Mailing Address - Street 2:103
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3022
Mailing Address - Country:US
Mailing Address - Phone:713-365-9100
Mailing Address - Fax:713-365-9101
Practice Address - Street 1:8831 LONG POINT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3022
Practice Address - Country:US
Practice Address - Phone:713-365-9100
Practice Address - Fax:713-365-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1088029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty