North East Rehab Center Willowbrook

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1081537 Issued in TX

Legal business name

NORTH EAST REHAB CENTER WILLOWBROOK

Practice address

13300 Hargrave Rd
Suite 490
Houston, TX 77070-4373

Phone

(281) 646-1935

Fax

(281) 646-0927

NPI assigned

Apr 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sandra Ann Shirah, ADMINISTRATOR

Title

Credentialing Supervisor

Phone

(281) 646-1935

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Thomas Mathew Doing business as

Tax ID family

North East Rehab Center Willowbrook3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• North East Rehab Parker

  • Physical Therapist
  • Houston, TX
  • NPI 1285851519
  NPD tax ID
• North East Rehab Woodlands

  • Physical Therapist
  • The Woodlands, TX
  • NPI 1366565566
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Mathew, LPT

  • Physical Therapist
  • Houston, TX
  • NPI 1639217169
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1245455963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 HARGRAVE RD",
            "address_2": "SUITE 490",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704373",
            "telephone_number": "281-646-1935",
            "fax_number": "281-646-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 HARGRAVE RD",
            "address_2": "SUITE 490",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704373",
            "telephone_number": "281-646-1935",
            "fax_number": "281-646-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST REHAB CENTER WILLOWBROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SHIRAH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "281-646-1935",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1081537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "1081537",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "650546",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas Mathew",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Houston, TX
• Providers in Houston, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.