MEDICARE: MEMORIAL REHABILITATION ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306840053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL REHABILITATION ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 710330
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77271-0330
Country	:	US
Telephone Number	:	713-744-2000
Fax Number	:	713-744-2001

Provider Business Practice Location Address
First Line	:	10910 S GESSNER RD
Second Line	:	BOX 710330
City	:	HOUSTON
State	:	TX
Zip	:	77071-3504
Country	:	US
Telephone Number	:	713-744-2000
Fax Number	:	713-744-2001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD HAROLD ROLNICK
Credential	:	M.D.
Telephone Number	:	713-744-2000

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	10/25/2013

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