MEDICARE: WESTON REHABILITATION TEXAS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1245531318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTON REHABILITATION TEXAS LLC

Provider Business Mailing Address
First Line	:	3131 ELLIOTT AVE
Second Line	:	SUITE 500
City	:	SEATTLE
State	:	WA
Zip	:	98121-1031
Country	:	US
Telephone Number	:	206-298-2909
Fax Number	:	206-301-4500

Provider Business Practice Location Address
First Line	:	2250 NORTH DOWLEN ROAD
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77706-2561
Country	:	US
Telephone Number	:	409-866-8090
Fax Number	:	409-866-2006

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GRANGER COBB
Credential	:
Telephone Number	:	206-298-2909

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	11/05/2010

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Directions to “WESTON REHABILITATION TEXAS LLC ” Practice Location

Language	Start Address	Practice Location

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