MEDICARE: E. HOUSTON REHAB.&MEDICAL SUPPLIES

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	332B00000X	Durable Medical Equipment & Medical Supplies	0089356	TX

General Provider Information

NPI Number	:	1548282643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E. HOUSTON REHAB.&MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	1717 E. LOOP NORTH FWY.
Second Line	:	300
City	:	HOUSTON
State	:	TX
Zip	:	77029-4032
Country	:	US
Telephone Number	:	713-673-9100
Fax Number	:	713-673-9101

Provider Business Practice Location Address
First Line	:	1717 E. LOOP NORTH FWY.
Second Line	:	300
City	:	HOUSTON
State	:	TX
Zip	:	77029-4032
Country	:	US
Telephone Number	:	713-673-9100
Fax Number	:	713-673-9101

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LAMISHA DEJON JOHNSON
Credential	:
Telephone Number	:	713-673-9100

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	08/22/2020

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