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General NPI Number Information
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NPI Number | 1700828381
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Entity Type | Organization
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Legal Business Name | HOPE REHAB LTD
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 850 FM 1960 RD W SUITE T
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City | HOUSTON
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State | TX
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Zip | 77090-3418
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Country | US
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Telephone | 832-249-6980
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Fax | 832-249-1021
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Provider Business Mailing Address
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Address Line | 19538 INDIGO LAKE DR
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City | MAGNOLIA
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State | TX
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Zip | 77355-3157
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Country | US
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Telephone | 281-252-3438
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Fax | 832-476-6351
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Authorized Official
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Title or Position | OWNER
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Name | MR. SAM FONTENOT
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Credential | PT
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Telephone | 281-252-3438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1001675
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License Number State | TX
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