Healthcare Provider Details

I. General information

NPI: 1366607954
Provider Name (Legal Business Name): MEMORIAL REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N COLLEGE AVE SUITE 1001
CLEVELAND TX
77327-4000
US

IV. Provider business mailing address

PO BOX 1816
CLEVELAND TX
77328-1816
US

V. Phone/Fax

Practice location:
  • Phone: 281-592-2426
  • Fax: 281-593-0060
Mailing address:
  • Phone: 291-592-2426
  • Fax: 281-593-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK6006
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberK6006
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberK6006
License Number StateTX

VIII. Authorized Official

Name: DR. INNAD H HUSAINI
Title or Position: PRESIDENT
Credential:
Phone: 281-592-2426