Provider Demographics
NPI:1609140821
Name:R@RHEATLH@REHABILITATIONCENTER
Entity Type:Organization
Organization Name:R@RHEATLH@REHABILITATIONCENTER
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:MS
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:A
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-690-1681
Mailing Address - Street 1:4625 NORTH FWY
Mailing Address - Street 2:201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-2914
Mailing Address - Country:US
Mailing Address - Phone:713-691-7471
Mailing Address - Fax:713-691-7771
Practice Address - Street 1:4101 NORTH FWY
Practice Address - Street 2:101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-4200
Practice Address - Country:US
Practice Address - Phone:713-691-7471
Practice Address - Fax:713-691-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0009838261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation