MEDICARE: WOODLANDS HAND REHABILITATION CENTER LLC

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	225XH1200X	Hand Occupational Therapist	539990000	TX

General Provider Information

NPI Number	:	1518070770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLANDS HAND REHABILITATION CENTER LLC

Provider Business Mailing Address
First Line	:	19073 INTERSTATE 45 S
Second Line	:	SUITE 145
City	:	THE WOODLANDS
State	:	TX
Zip	:	77385-8743
Country	:	US
Telephone Number	:	936-321-4700
Fax Number	:	936-321-4848

Provider Business Practice Location Address
First Line	:	19073 INTERSTATE 45 S
Second Line	:	SUITE 145
City	:	CONROE
State	:	TX
Zip	:	77385-8744
Country	:	US
Telephone Number	:	936-321-4700
Fax Number	:	936-321-4848

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MOLLY M HUDSON
Credential	:	OTR,CHT
Telephone Number	:	936-321-4700

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	08/12/2008

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