Healthcare Provider Details

I. General information

NPI: 1053850362
Provider Name (Legal Business Name): CENTRA REHAB & THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 COMMERCE PARK DR 155
HOUSTON TX
77036-7497
US

IV. Provider business mailing address

8700 COMMERCE PARK DR 155
HOUSTON TX
77036-7497
US

V. Phone/Fax

Practice location:
  • Phone: 713-701-7993
  • Fax: 832-553-7626
Mailing address:
  • Phone: 713-701-7993
  • Fax: 832-553-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number225XG0600X
License Number StateTX

VIII. Authorized Official

Name: DEBBIE AKINTUNDE
Title or Position: ADMINISTRATOR
Credential:
Phone: 713-701-7993