Provider Demographics
NPI:1396828117
Name:HOUSTON INJURY & REHAB CENTER, INC
Entity Type:Organization
Organization Name:HOUSTON INJURY & REHAB CENTER, INC
Other - Org Name:UNITED HEALTH EAST CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WALID
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAMOUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-330-9100
Mailing Address - Street 1:2626 S. LOOP WEST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5613
Mailing Address - Country:US
Mailing Address - Phone:713-669-1090
Mailing Address - Fax:713-669-1091
Practice Address - Street 1:10932 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1912
Practice Address - Country:US
Practice Address - Phone:713-330-9100
Practice Address - Fax:713-330-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231091041C0700X
TXK7027208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z346Medicare PIN