MEDICARE: ADMORE PHYSICAL & SPEECH REHAB, 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1346485968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADMORE PHYSICAL & SPEECH REHAB, LLC

Provider Business Mailing Address
First Line	:	5821 SOUTHWEST FWY STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7501
Country	:	US
Telephone Number	:	281-888-4646
Fax Number	:	713-910-0358

Provider Business Practice Location Address
First Line	:	7015 GULF FWY
Second Line	:	STE 231
City	:	HOUSTON
State	:	TX
Zip	:	77087-2502
Country	:	US
Telephone Number	:	281-888-4646
Fax Number	:	281-888-9210

Authorized Official
Title or Position	:	CFO
Name	:	ABIGAIL N WYNNE
Credential	:
Telephone Number	:	713-910-0296

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	04/05/2018

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