MEDICARE: DEPT OF ASSISTIVE & REHAB SERV - HOUSTON FIELD HEADQUARTERS

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	251B00000X	Case Management Agency		TX

General Provider Information

NPI Number	:	1801929542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPT OF ASSISTIVE & REHAB SERV - HOUSTON FIELD HEADQUARTERS

Provider Business Mailing Address
First Line	:	PO BOX 12866
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78711-2866
Country	:	US
Telephone Number	:	512-377-0584
Fax Number	:

Provider Business Practice Location Address
First Line	:	427 W 20TH ST STE 407
Second Line	:	HEIGHTS MEDICAL TOWER
City	:	HOUSTON
State	:	TX
Zip	:	77008-2430
Country	:	US
Telephone Number	:	713-802-3100
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	JOSEPH PAYNE
Credential	:
Telephone Number	:	512-424-4092

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

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