MEDICARE: PHYSICAL REHAB SERVICES, INC.,

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	251E00000X	Home Health Agency	010356	TX

General Provider Information

NPI Number	:	1598714412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL REHAB SERVICES, INC.,

Provider Business Mailing Address
First Line	:	6201 BONHOMME RD
Second Line	:	SUITE 345N
City	:	HOUSTON
State	:	TX
Zip	:	77036-4365
Country	:	US
Telephone Number	:	713-784-7781
Fax Number	:	713-784-7785

Provider Business Practice Location Address
First Line	:	6201 BONHOMME RD
Second Line	:	SUITE 345N
City	:	HOUSTON
State	:	TX
Zip	:	77036-4365
Country	:	US
Telephone Number	:	713-784-7781
Fax Number	:	713-784-7785

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ANONG A INTARAKOMHEANG
Credential	:
Telephone Number	:	713-784-7781

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	08/22/2020

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Directions to “PHYSICAL REHAB SERVICES, INC., ” Practice Location

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