Rehoboth Medical Center PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REHOBOTH MEDICAL CENTER PLLC

Practice address

25231 Roesner LN
Katy, TX 77494-5537

Phone

(281) 506-7412

Fax

(281) 530-2882

NPI assigned

Nov 5, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Stella Grace Immanuel, MDNPI 1902947120

Title

Medical Director

Phone

(281) 506-7412

Specialties & licenses 3

Addresses

Electronic endpoints 1

Tax ID family

Rehoboth Medical Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Rehoboth Medical Center LLC

  • Pediatrics Physician
  • Katy, TX
  • NPI 1255977583
  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.

• Stella Grace Immanuel, MD

  • Family Medicine Physician
  • Katy, TX
  • NPI 1902947120
  NPD Authorized official

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1386288116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25231 ROESNER LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945537",
            "telephone_number": "281-506-7412",
            "fax_number": "281-530-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25231 ROESNER LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945537",
            "telephone_number": "281-506-7412",
            "fax_number": "281-530-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6718 Highway 6 S",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770831512",
            "country_code": "US",
            "telephone_number": "281-506-7412",
            "fax_number": "281-530-2882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REHOBOTH MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "IMMANUEL",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "281-506-7412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@rehobothmedicalcenter.com",
            "affiliation": "N",
            "address_1": "25231 Roesner Ln",
            "city": "Katy",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774945537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sasha Reeves
• Regenerative Medical and Wellness Centers
• Rehab and Family Practice of Texas LLC
• Rehab Network
• Rehoboth Medical Center LLC
• Rehoboth Medical Clinics PLLC
• Rehoboth Wellness Center PLLC
• Heather Reichert, R.D., C.D.E.
• Christina Jean Reid, PT, DPT
• Yvette M Reilly, RNFA

• Family Medicine Physician in Katy, TX
• Providers in Katy, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.