Provider Demographics
NPI:1801848940
Name:WEST HOUSTON REHABILITATION ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:WEST HOUSTON REHABILITATION ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-984-9595
Mailing Address - Street 1:PO BOX 925510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77292-5510
Mailing Address - Country:US
Mailing Address - Phone:713-984-9595
Mailing Address - Fax:713-984-8576
Practice Address - Street 1:1044 CANDLELIGHT LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-2004
Practice Address - Country:US
Practice Address - Phone:713-984-9595
Practice Address - Fax:713-984-8576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082039101Medicaid
TX00D48CMedicare ID - Type UnspecifiedMEDICARE GROUP PROV NUM
TX082039101Medicaid